Ambulatory searching task reveals importance of somatosensation for lower-limb amputees
Open accessAbstract
The contribution of somatosensation to locomotor deficits in below-knee amputees (BKAs) has not been fully explored. Unilateral disruption of plantar sensation causes able-bodied individuals to adopt locomotor characteristics that resemble those of unilateral BKAs, suggesting that restoring somatosensation may improve locomotion for amputees. In prior studies, we demonstrated that electrically stimulating the residual nerves of amputees elicited somatosensory percepts that were felt as occurring in the missing foot. Subsequently, we developed a sensory neuroprosthesis that modulated stimulation-evoked sensation in response to interactions between the prosthesis and the environment. To characterize the impact of the sensory neuroprosthesis on locomotion, we created a novel ambulatory searching task. The task involved walking on a horizontal ladder while blindfolded, which engaged plantar sensation while minimizing visual compensation. We first compared the performance of six BKAs to 14 able-bodied controls. Able-bodied individuals demonstrated higher foot placement accuracy than BKAs, indicating that the ladder test was sensitive enough to detect locomotor deficits. When three of the original six BKAs used the sensory neuroprosthesis, the tradeoff between speed and accuracy significantly improved for two of them. This study advanced our understanding of how cutaneous plantar sensation can be used to acquire action-related information during challenging locomotor tasks.
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Extraneural electrodes are generally simple to implant and have shown selective stimulation in multiple long-term clinical trials for motor and sensory restoration.
“Although they require the nerve to be freed from the surrounding tissues, extraneural electrodes are generally simple to implant [15] and have shown selective stimulation in multiple long-term clinical trials for motor and sensory restoration [16-18].”
From Directed stimulation with interfascicular interfaces for peripheral nerve stimulation (2021) · cites this paper as [18]
The citation to this paper falls in the second clause, not the claim that the electrodes are simple to implant. In Materials and methods, “Closed-loop sensory neuroprosthesis” (page not provided), Christie et al. describe chronically implanted nerve electrodes in three amputees and contacts selected to evoke sensations in different regions of the missing foot. This supports selective sensory stimulation, but this paper does not establish motor restoration or, by itself, multiple long-term clinical trials. (LLM, conf=0.86)
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References 55 · Cited by 37
- Authors
- Christie, B. P., Charkhkar, H., Shell, C. E., Burant, C. J., Tyler, D. J., & Triolo, R. J.
- Affiliations
- Louis Stokes Cleveland VA Medical Center (US)
- Cleveland Clinic (US)
- Corresponding author
- Christie, Breanne P.
- ORCID
- Venue
- Scientific Reports
- Published
- 2020-06-23
- Volume
- 10
- Issue
- 1
- Pages
- 10216-10216
- ISSN
- 2045-2322 (ISSN-L)
- PMC
- PMC7311393
- OpenAlex
- W3036556269
- Cited by
- 37
- References
- 55
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 4 · 2023: 12 · 2022: 5 · 2021: 7
- FWCI
- 1.88
- Type
- journal article
- Language
- en
- Update notices
- correction (2022-08-16)
- Open access
- gold
- doi.org
- Locations
- Scientific Reports (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- United States Department of Defense | Defense Advanced Research Projects Agency (N66001-15-C-4038)
- Topics
- Physical Sciences › Engineering › Biomedical Engineering › Prosthetics and Rehabilitation Robotics
- Physical Sciences › Engineering › Biomedical Engineering › Muscle activation and electromyography studies
- Life Sciences › Neuroscience › Cognitive Neuroscience › Tactile and Sensory Interactions
- Keywords
- transtibial amputation, somatosensory perception, plantar sensation, lower limb amputees, blindfolded walking, speed-accuracy trade-off, locomotor deficits
- MeSH terms
- Adult, Ambulatory Care, Amputees, Artificial Limbs, Biomechanical Phenomena, Female, Gait, Humans, Male, Somatosensory Cortex, Case-Control Studies, Walking, Lower Extremity, Feedback, Sensory
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