Utilizing additive manufacturing and gamified virtual simulation in the design of neuroprosthetics to improve pediatric
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Research Letter
Utilizing additive manufacturing and gamified virtual simulation in the design of neuroprosthetics to improve pediatric outcomes Albert Manero II , Peter Smith , John Sparkman, Matt Dombrowski, and Dominique Courbin, Limbitless Solutions, University of Central Florida, 4217 E Plaza Drive, Orlando, FL 32816, USA Paul Barclay, Department of Psychology, University of Central Florida, 4000 Central Florida Blvd, Orlando, FL 32816, USA Albert Chi, Division of Trauma, Critical Care and Acute Care Surgery, Department of Surgery, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA Address all correspondence to Albert Manero II at [email protected]; Albert Chi at [email protected] (Received 1 June 2019; accepted 22 July 2019)
Abstract Additive manufacturing used with custom electromyographic sensors has been demonstrated for neuroprosthetic limb manufacturing and is now translating to the clinical environment. These manufacturing methods have dramatically reduced device weight while increasing the capability for multi-finger dexterity. Using wearable electromyography sensors standalone from the prosthetic limb, a new virtual training method has been designed and tested to improve human–machine interaction. This type of training leverages real-time visual feedback to user inputs, supporting improved timing and magnitudes of muscle contractions. The combination of these technologies may provide a stronger affinity between the pediatric patient group and the device.
Introduction Access and adoption of advanced prosthetics for children have traditionally been limited due to a variety of factors including high costs, limited insurance coverage options, challenges in adaptation and training leading to high rejection rates, and limitations in technology or performance.[1] These factors have driven prescribers and insurers to limit prescriptions of advanced prosthetics for children with congenital amputations, which occurs in approximately 5 out of every 10,000 live births.[2–4] For children, device usage rates with transverse upper limb amputations[5] are reported between 44% and 66%.[6–8] The cause of rejection is still a point of great research interest and has been reported to be caused by a number of factors. The availability of affordable access coupled with esthetic design is often identified as two of the most important driving factors.[1] Postema et al.[9] surveyed both parents and children between the ages of 6 and 19 and found driving factors of prosthesis rejection to include (i) a lack of functional gain, (ii) unattractive appearance, (iii) insufficient match of functionality expectations, (iv) parents’ disappointment, (v) inadequate socioemotional guidance by the medical team, and (vi) the device overall weight. The team also reported that children over the age of 15 years old had high rejection rates of approximately 44%, and their responses did not reflect the device’s appearance as a driving factor. Hermansson et al.[10] has reported on the role of gende
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