A third arm - Design of a bypass prosthesis enabling incorporation.

A variety of factors affect the performance of a person using a myoelectric prosthesis, including increased control noise, reduced sensory feedback, and muscle fatigue. Many studies use able-bodied subjects to control a myoelectric prosthesis using a bypass socket in order to make comparisons to movements made with intact limbs. Depending on the goals of the study, this approach can also allow for greater subject numbers and more statistical power in the analysis of the results. As we develop assessment tools and techniques to evaluate how peripheral nerve interfaces impact prosthesis incorporation, involving normally limbed subjects in the studies becomes challenging. We have designed a novel bypass prosthesis to allow for the assessment of prosthesis incorporation in able-bodied subjects. Incorporation of a prosthetic hand worn by a normally limbed subject requires that the prosthesis is a convincing, functional extension of their own body. We present the design and development of the bypass prosthesis with special attention to mounting position and angle of the prosthetic hand, the quality of the control system and the responsiveness of the feedback. The bypass prosthesis has been fitted with a myoelectrically-controlled hand that has been instrumented to measure the forces applied to the thumb, index, and middle fingers. The prosthetic hand was mounted on the bypass socket such that it is the same length as the subject's intact limb but at a medial rotation angle of 20° to prevent visual occlusion of the prosthetic hand. Force feedback is provided in the form of electrical stimulation, vibration, or force applied to the intact limb with milliseconds of delay. Preliminary data results from a cross-modal congruency task are included showing evidence of prosthesis incorporation in able-bodied subjects. This bypass will allow able-bodied subjects to participate in research studies that require the use of a prosthetic limb while also allowing the subjects to sense that the prosthesis is an extension of the body.