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DESIGN OF UPPER LIMB PROSTHESES:

A NEW SUBJECT-ORIENTED APPROACH


MARCO TRONCOSSI1,VINCENZO PARENTI-CASTELLI1 and ANGELO DAVALLI2
1

DIEM Department of Mechanical Engineering, University of Bologna,


Viale del Risorgimento 2, 40136 Bologna, Italy
marco.troncossi@mail.ing.unibo.it
2
I.N.A.I.L. Prosthetic Center, Vigorso di Budrio (Bologna), Italy

The challenge to develop innovative prostheses for upper limb amputees is the basis of this
study. The whole project is intended to provide high-level bilateral amputees with devices
which can give them back a sufficient quality of life, since current prostheses are rather
limited. High mobility, advanced control and good wearability are the main features
required of artificial arms. The method presented here provides the specifications needed to
guide the mechanical design of the prosthetic system, defining its architecture as a trade-off
solution between contrasting requirements like, for instance, functionality and simplicity. The
approach is subject-oriented, that is the process is based upon the specific needs of patients
undergoing prosthetic rehabilitation and the expected result is the systematic determination of
a limited number of prosthesis architectures suitable to a few corresponding classes of
amputee profiles. Thus, the mechanical design of the prosthetic system is based on these
indications.
Keywords: Upper limb amputees; Externally powered prostheses; Subject-oriented design;
Serial robot architecture; Limited degrees of freedom robots; Performance indices.

1. Introduction
Nowadays, the most advanced prosthetic device for upper limb amputees is the myoelectric
prosthesis: here, electromechanical joints actuate the artificial arm segments and are directly
activated by the amputee by means of electromyographic (EMG) signals, to be measured on
the skin by sensors (myoelectric electrodes) and processed by a programmable control circuit
(primary control scheme); rechargeable batteries power all these components. Some passive
joints and/or locking mechanisms are sometimes included in the system and are useful to give
the prosthetic limb an optimal pre-determined configuration when performing certain tasks.
They are configured with non-myoelectric inputs before or after the direct control of the
active joints (secondary control scheme). The generation of independent EMG signals (which
are due to unrelated contraction of distinct bundles of muscles) implies a sequential control of
the articulations, i.e. only one joint at a time can be activated. The good qualities of this
prosthesis are a sufficient functionality, good performances (in terms of speed and forces) and
a pleasant appearance. The critical aspects are the weight and the volume of the structure, and
the complicated control (union of the primary and the secondary control schemes); therefore,
in order to provide the amputee with a comfortable, humanlike and easy to control prosthesis

(otherwise not accepted), not all the physiological joint movements can be replicated, thus
limiting the flexibility and functionality of the artificial arm. As regards the human arm, the
dexterity of a prosthesis is very poor and the amputee has to resort to compensatory
movements of the residual limb, or even of other parts of the body, to execute many motor
tasks; of course, the higher the level of amputation the greater the encountered difficulties.
To succeed in the prosthetic rehabilitation, the practitioner has to choose appropriate arm
components and control schemes that best suit the patients level of amputation, size, tissue
and musculature conditions, range of motion, learning ability, vocational and avocational
goals 1. Even the prosthesis architecture, i.e. the geometry and the topology of the artificial
arm, must be selected taking into account the personal needs and expectations of the patient,
providing him/her with the prosthesis which best matches his/her specific requirements.
Unfortunately, the possibility of choice is nowadays rather limited: besides the terminal
device (with only one degree of freedom for grasping) and a number of passive joints and
locking mechanisms, only two electromechanical active joints (the most meaningful, from a
functional viewpoint) are available on the market: the prono-supination unit and the elbow.
For very high level amputees (bilateral, above all), who have an extremely restricted residual
movement ability, current prostheses could be inadequate to guarantee the functionality
needed to reach a satisfactory level of autonomy.
Thus, in order to solve this lack and to improve the quality of life of this amputee population,
the I.N.A.I.L. Prosthetic Center is supervising a project whose aim is the development of new
electrically powered prostheses with a great mobility, an advanced control and a good
wearability (i.e. tolerable weight, user friendliness, humanlike appearance). In order to
draw up the project guidelines, a method which determines the optimal answer to contrasting
demands has been set up, and is outlined here; the approach is subject-oriented, that is the
algorithm associates a given patient with the architecture of the artificial arm which best
satisfies his/her personal requirements, taking into account different, contrasting aspects.
Architecture is intended as the geometry and the topology of a robotic arm model, i.e. the
number of active joints and their arrangements. The results of the method, applied to many
patient profiles, offer the mechanical design specifications of the new components to be
introduced in the system.
2. Methods
The most important factors in designing upper limb prostheses are functionality and
wearability, that is the artificial arms should have a humanlike appearance, should be
flexible and efficient and, at the same time, easy to control and comfortable to wear, i.e. with
a light and simple structure. These features are in conflict with respect to each other so that a
trade-off has to be found. We believe that even during the design process the relative
importance to be given to each factor must strictly depend on the patients profile. The
approach followed to tackle the problem aims at determining a limited number of prosthesis
architectures which best suit all the requirements of corresponding classes of high-level
amputees.
An original procedure which systematically collects and processes a great deal of information
relative to a given subject has been proposed 2 ; the procedure foresees a given patient as the
input and provides his/her corresponding optimal prosthesis architecture as the output. The
application of the procedure to many patient profiles is expected to provide a limited number
of significant architectures which can satisfactorily match the needs of different amputees.
The arrangement of the active joints in the robotic arm models and other information
detectable from the procedure generate the design specifications for the development of the
most appropriate prostheses. In particular, the degrees of freedom (DoF) and the

corresponding range of motion of articulations to be adopted in the forthcoming design are


defined. This is the starting point of the mechanical design of innovative prosthetic devices.
2.1 The Procedure
As described in Ref. 2, the procedure processes appropriate information of a given patient and
designates his/her optimal prosthesis architecture, i.e. the artificial arm model which can best
satisfy his/her personal needs. A database collects, on one side, upper limb activities of daily
living and the corresponding reference trajectories which model them (normally requiring six
DoF for positioning and orienting tasks), and, on the other, several kinematic models of
anthropomorphic robots (with one up to six revolute joints differently arranged). The
procedure is composed of three sequential steps, running automatically once the proper
amputee data are given.
Step 1. The input of the procedure is an identification-form of the patient, that collects all the
information necessary to classify the amputees needs: different aspects are investigated in
order to define a personalized level of life quality to be reached after the prosthetic
rehabilitation process (by means of proper devices). The answer to each question in the form
is to be selected from a number of pre-defined options; the responses are codified with proper
labels in order to systematically portray a well-defined patient profile.
An algorithm determines which upper limb activities are most significant for the patient from
the viewpoint of reaching a satisfactory functional autonomy in everyday living. The
algorithm also determines the values of parameters involved in the final selection of the best
architecture (see Step 3) by weighting the relative relevance of the different factors which
contribute to define the amputees quality of life (e.g. functionality of the device, simplicity of
the structure, easiness of control).
Step 2. Kinematic simulations check the robotic model ability to satisfactorily perform the
selected activities, i.e. to follow the corresponding reference trajectories.
A further kinetostatic analysis calculates the torque and the power required at all the actuated
joints when performing the tasks, defining a first approximation of the size of their actuators.
The models with less than six DoF (limited robots) correspond to simpler robot architectures
and thus are appreciated from the wearability viewpoint; on the other side, their performances
are poorer than those of the 6 DoF models, because they execute the tasks with an error which
increases as the number of active joints decreases. The structure simplification of the limited
robots and the corresponding worsening of their global functionality have to be evaluated
with respect to the quality of life assigned to the given patient, as depicted from the previous
characterization algorithm (in Step 1).
Step 3. Finally, the artificial arm models have to be evaluated: their performances and the
complexity of their architecture are measured by purpose-built indices which, properly
combined in an overall index (i.e. weighted by the above mentioned subject-dependent
parameters), univocally determine the optimal prosthesis architecture, i.e. the robotic arm
with the simplest and lightest structure which can best satisfy the patients personal needs.
2.2 Architecture selection
It is not feasible to design an ad-hoc prosthesis for each patient, because it would be a too
expensive process. Therefore, the procedure is intended to be applied to a huge number of
patient profiles (theoretically, considering all the possible combinations of the identificationform labels) in order to define a limited selection of optimal or sub-optimal prosthesis
architectures suitable to match different amputee requirements. Sub-optimal is intended as
an artificial arm model with good responses (even if not the best) to different amputee
requirements, i.e. an architecture characterized by high value of the overall index (even if not
the maximum) for several patient profiles. From a feasibility viewpoint the choice of a

versatile, sub-optimal architecture is more sensible than aiming to provide each subject with
the best prosthetic device designed on his/her individual demands.
3 Practical application
The results of the presented approach can guide the practitioners to choose the appropriate
solution for patients to be fitted with a new prosthesis, on the basis of a systematical process.
It might happen that the architecture indicated for a given patient (presumably a high-level
amputee) corresponds to no devices available on the market. Thus, the design of new
components to be introduced in prosthetic systems is required. The present method is useful
for this aim too (Fig. 1), defining which new active articulations must be designed. In
particular, the arrangement of the joints in the arm models determines the kind of motion
which the new articulations must actuate; the results of the kinematic and kinetostatic
simulations respectively define the range of motion of the joints and the mechanical
characteristics (peak and RMS values of torque and power) of the corresponding
electromechanical actuators. Thus, in this way, the fundamentals mechanical design
specifications are determined.

Step 1:

Procedure
Step 2:

Patients
profile
characterization

Kinematic
and
kinetostatic
simulations

Patient 1
Patient 2

Patient n

MECHANICAL DESIGN
of new articulations

Architecture 1

Example

Step 3:
Arm
models
evaluation

Architecture m
m<<n

Range of motion
Torque
Power

Joint not available


on the
market

Fig. 1: Conceptual block schemes of the approach. A possible arm architecture has been drafted as example.

4. Discussion
The basis for this study comes from the challenge to develop an innovative upper limb
prosthesis for very high-level amputees, improving both the mobility and the control schemes
of the present devices. This paper outlined the approach followed for the determination of the
mechanical design specifications. The method relies upon a procedure which, properly used,
determines a limited selection of prosthesis architectures suitable to fit the needs of
corresponding classes of patient profiles. Qualitative and quantitative outcomes provide the
input for the design of new electromechanical articulations to be considered in a prosthetic
system.
References
1. Miguelez J.M., Critical Factors in Electrically Powered Upper-Extremity Prosthetics,
JPO 14 (1), 2002, 36-38
2. Parenti Castelli V., Troncossi M., Sacchetti R., A Procedure for the Determination of
the Optimal Upper Limb Prosthesis Architecture, Proceedings of RAAD04, 13th
Workshop on Robotics in Alpe-Adria-Danube Region, Brno, Czech Republic,June 2-5,
2004, 134-139.