title: An exploration of grip force regulation with a low-impedance myoelectric prosthesis featuring referred haptic feedback.
abstract: BACKGROUND
  Haptic display technologies are well suited to relay proprioceptive, force, and contact cues from a prosthetic terminal device back to the residual limb and thereby reduce reliance on visual feedback. The ease with which an amputee interprets these haptic cues, however, likely depends on whether their dynamic signal behavior corresponds to expected behaviors-behaviors consonant with a natural limb coupled to the environment. A highly geared motor in a terminal device along with the associated high back-drive impedance influences dynamic interactions with the environment, creating effects not encountered with a natural limb. Here we explore grasp and lift performance with a backdrivable (low backdrive impedance) terminal device placed under proportional myoelectric position control that features referred haptic feedback.
  
  
  METHODS
  We fabricated a back-drivable terminal device that could be used by amputees and non-amputees alike and drove aperture (or grip force, when a stiff object was in its grasp) in proportion to a myoelectric signal drawn from a single muscle site in the forearm. In randomly ordered trials, we assessed the performance of N=10 participants (7 non-amputee, 3 amputee) attempting to grasp and lift an object using the terminal device under three feedback conditions (no feedback, vibrotactile feedback, and joint torque feedback), and two object weights that were indiscernible by vision.
  
  
  RESULTS
  Both non-amputee and amputee participants scaled their grip force according to the object weight. Our results showed only minor differences in grip force, grip/load force coordination, and slip as a function of sensory feedback condition, though the grip force at the point of lift-off for the heavier object was significantly greater for amputee participants in the presence of joint torque feedback. An examination of grip/load force phase plots revealed that our amputee participants used larger safety margins and demonstrated less coordination than our non-amputee participants.
  
  
  CONCLUSIONS
  Our results suggest that a backdrivable terminal device may hold advantages over non-backdrivable devices by allowing grip/load force coordination consistent with behaviors observed in the natural limb. Likewise, the inconclusive effect of referred haptic feedback on grasp and lift performance suggests the need for additional testing that includes adequate training for participants.
authors.affiliation: Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, USA. jdelaine@umich.edu.|Mechanical Engineering and Applied Mechanics, University of Pennsylvania, Philadelphia, PA, USA. jdelaine@umich.edu.
authors.forename: Jeremy D
authors.initials: JD
authors.lastname: Brown
authors.affiliation: Department of Electrical and Computer Engineering, University of Houston, Houston, TX, USA. aypaek@uh.edu.
authors.forename: Andrew
authors.initials: A
authors.lastname: Paek
authors.affiliation: School of Biomedical Engineering, Science and Health Systems (BIOMED), Drexel University, Philadelphia, PA, USA. mms382@drexel.edu.
authors.forename: Mashaal
authors.initials: M
authors.lastname: Syed
authors.affiliation: Department of Mechanical Engineering, Rice University, Houston, TX, USA. omalleym@rice.edu.
authors.forename: Marcia K
authors.initials: MK
authors.lastname: O'Malley
authors.affiliation: School of Biomedical Engineering, Science and Health Systems (BIOMED), Drexel University, Philadelphia, PA, USA. pas38@drexel.edu.|Nutrition Sciences Department, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA. pas38@drexel.edu.|Department of Surgery, Drexel University College of Medicine, Philadelphia, PA, USA. pas38@drexel.edu.
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Shewokis
authors.affiliation: Department of Electrical and Computer Engineering, University of Houston, Houston, TX, USA. jlcontreras-vidal@central.uh.edu.
authors.forename: Jose L
authors.initials: JL
authors.lastname: Contreras-Vidal
authors.affiliation: UM Orthotics and Prosthetics Center, University of Michigan, Ann Arbor, MI, USA. aliciad@med.umich.edu.
authors.forename: Alicia J
authors.initials: AJ
authors.lastname: Davis
authors.affiliation: Department of Mechanical Engineering, University of Michigan, Ann Arbor, MI, USA. brentg@umich.edu.
authors.forename: R Brent
authors.initials: RB
authors.lastname: Gillespie
mesh_terms: D000328:Adult; D000674:Amputees / Q000534:rehabilitation*; D001186:Artificial Limbs; D017097:Electric Impedance; D056228:Feedback, Sensory / Q000502:physiology*; D005260:Female; D005542:Forearm; D018737:Hand Strength / Q000502:physiology*; D006801:Humans; D008297:Male; D055815:Young Adult