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Current lower-limb prostheses do not provide active assistance in postural control tasks to maintain the user’s balance, particularly in situations of perturbation. In this study, we aimed to address this missing function by enabling neural control of robotic lower-limb prostheses. Specifically, electromyographic (EMG) signals (amplified neural control signals) recorded from antagonistic residual ankle muscles were used to drive a robotic prosthetic ankle directly and continuously. Participants with transtibial amputation were recruited and trained in using the EMG-driven robotic ankle. We studied how using the EMG-controlled ankle affected the participants’ anticipatory and compensatory postural control strategies and stability under expected perturbations compared with using their daily passive devices. We investigated the similarity of neuromuscular coordination (by analyzing motor modules) of the participants, using either device in a postural sway task, to that of able-bodied controls. Results showed that, compared with their passive prosthesis, the EMG-controlled prosthesis enabled participants to use near-normative postural control strategies, as evidenced by improved between-limb symmetry in intact-prosthetic center-of-pressure and joint angle excursions. Participants substantially improved postural stability, as evidenced by a reduction in steps or falls using the EMG-controlled prosthetic ankle. Furthermore, after relearning to use residual ankle muscles to drive the robotic ankle in postural control, nearly all participants’ motor module structure shifted toward that observed in individuals without limb amputations. Here, we have demonstrated the potential benefit of direct EMG control of robotic lower limb prostheses to restore normative postural control strategies (both neural and biomechanical) toward enhancing standing postural stability in amputee users. 

Amputees’ preferences for prosthesis settings are critical not only for their psychological well-being but also for long-term adherence to device adoption and health. Although active lower-limb prostheses can provide enhanced functionality than passive devices, little is known about the mechanism of preferences for settings in active devices. Therefore, a think-aloud study was conducted on three amputees to unravel their preferences for a powered robotic knee prosthesis during user-guided auto-tuning. The inductive thematic analysis revealed that amputee patients were more likely to use their own passive device rather than the intact leg as the reference for the natural walking that they were looking for in the powered device. There were large individual differences in factors influencing naturalness. The mental optimization of preference decisions was mostly based on the noticeableness of the differences between knee profiles. The implications on future design and research in active prostheses were discussed. 

Abstract Objective. Neural signals in residual muscles of amputated limbs are frequently decoded to control powered prostheses. Yet myoelectric controllers assume muscle activity of residual muscle is similar to that of intact muscle. This study sought to understand potential changes to motor unit (MU) properties after limb amputation. Approach. Six people with unilateral transtibial amputation were recruited. Surface electromyogram (EMG) of residual and intact tibialis anterior (TA) and gastrocnemius (GA) muscles were recorded while subjects traced profiles targeting up to 20 and 35% of maximum activation for each muscle (isometric for intact limbs). EMG was decomposed into groups of motor unit (MU) spike trains. MU recruitment thresholds, action potential amplitudes (MU size), and firing rates were correlated to model Henneman’s size principle, the onion-skin phenomenon, and rate-size associations. Organization (correlation) and modulation (rates of change) of relations were compared between intact and residual muscles. Main results. The residual TA exhibited significantly lower correlation and flatter slopes in the size principle and onion-skin, and each outcome covaried between the MU relations. The residual GA was unaffected for most subjects. Subjects trained prior with myoelectric prostheses had minimally affected slopes in the TA. Rate-size association correlations were preserved, but both residual muscles exhibited flatter decay rates. Significance. We showed peripheral neuromuscular damage also leads to spinal-level functional reorganization. Our findings suggest models of MU recruitment and discharge patterns for residual muscle EMG generation need reparameterization to account for disturbances observed. In the future, tracking MU pool adaptations may also provide a biomarker of neuromuscular control to aid training with myoelectric prostheses. 

Healthy human locomotion functions with good gait symmetry depend on rhythmic coordination of the left and right legs, which can be deteriorated by neurological disorders like stroke and spinal cord injury. Powered exoskeletons are promising devices to improve impaired people's locomotion functions, like gait symmetry. However, given higher uncertainties and the time-varying nature of human-robot interaction, providing personalized robotic assistance from exoskeletons to achieve the best gait symmetry is challenging, especially for people with neurological disorders. In this paper, we propose a hierarchical control framework for a bilateral hip exoskeleton to provide the adaptive optimal hip joint assistance with a control objective of imposing the desired gait symmetry during walking. Three control levels are included in the hierarchical framework, including the high-level control to tune three control parameters based on a policy iteration reinforcement learning approach, the middle-level control to define the desired assistive torque profile based on a delayed output feedback control method, and the low-level control to achieve a good torque trajectory tracking performance. To evaluate the feasibility of the proposed control framework, five healthy young participants are recruited for treadmill walking experiments, where an artificial gait asymmetry is imitated as the hemiparesis post-stroke, and only the ‘paretic’ hip joint is controlled with the proposed framework. The pilot experimental studies demonstrate that the hierarchical control framework for the hip exoskeleton successfully (asymmetry index from 8.8% to − 0.5%) and efficiently (less than 4 minutes) achieved the desired gait symmetry by providing adaptive optimal assistance on the ‘paretic’ hip joint. 

Objective: In this study, we aimed to develop a novel electromyography (EMG)-based neural machine interface (NMI), called the Neural Network-Musculoskeletal hybrid Model (N2M2), to decode continuous joint angles. Our approach combines the concepts of machine learning and musculoskeletal modeling. Methods: We compared our novel design with a musculoskeletal model (MM) and 2 continuous EMG decoders based on artificial neural networks (ANNs): multilayer perceptrons (MLPs) and nonlinear autoregressive neural networks with exogenous inputs (NARX networks). EMG and joint kinematics data were collected from 10 non-disabled and 1 transradial amputee subject. The offline performance tested across 3 different conditions (i.e., varied arm postures, shifted electrode locations, and noise-contaminated EMG signals) and online performance for a virtual postural matching task was quantified. Finally, we implemented the N2M2 to operate a prosthetic hand and tested functional task performance. Results: The N2M2 made more accurate predictions than the MLP in all postures and electrode locations (p < 0.003). For estimated MCP joint angles, the N2M2 was less sensitive to noisy EMG signals than the MM or NARX network with respect to error (p < 0.032) as well as the NARX network with respect to correlation (p = 0.007). Additionally, the N2M2 had better online task performance than the NARX network (p ≤ 0.030). Conclusion: Overall, we have found that combining the concepts of machine learning and musculoskeletal modeling has resulted in a more robust joint kinematics decoder than either concept individually. Significance: The outcome of this study may result in a novel, highly reliable controller for powered prosthetic hands. 

Abstract Achieving multicapability in a single soft gripper for handling ultrasoft, ultrathin, and ultraheavy objects is challenging due to the tradeoff between compliance, strength, and precision. Here, combining experiments, theory, and simulation, we report utilizing angle-programmed tendril-like grasping trajectories for an ultragentle yet ultrastrong and ultraprecise gripper. The single gripper can delicately grasp fragile liquids with minimal contact pressure (0.05 kPa), lift objects 16,000 times its own weight, and precisely grasp ultrathin, flexible objects like 4-μm-thick sheets and 2-μm-diameter microfibers on flat surfaces, all with a high success rate. Its scalable and material-independent design allows for biodegradable noninvasive grippers made from natural leaves. Explicitly controlled trajectories facilitate its integration with robotic arms and prostheses for challenging tasks, including picking grapes, opening zippers, folding clothes, and turning pages. This work showcases soft grippers excelling in extreme scenarios with potential applications in agriculture, food processing, prosthesis, biomedicine, minimally invasive surgeries, and deep-sea exploration.