The Usability of Percutaneous EMG for Prosthetic Control

Jerel Okonski
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Every year, 185,000 people become an amputee in the United States-more than 500

Americans every day (Ziegler-Graham et al.). For many, an amputation, which is most

frequently caused by a vascular disease or a traumatic injury, will prohibit a normal lifestyle,

turning simple everyday tasks into more complex endeavors. Modern advances in prosthetic

technology, however, are beginning to break the barriers that previously inhibited those with

limb loss. An ongoing challenge in the field of prosthetics is the integration of man with

machine- the ability to control robotic prosthetics when they are attached to human body parts.

Although there are multiple control methods used today, one of the most promising is the use of

myoelectric signals (MES), the electrical signals produced by the contraction of skeletal muscles,

to control prosthetics in a process called electromyography (EMG). MES are detected by two

types of electrical conductors, surface electrodes which sit on top of the skin and percutaneous

electrodes which are embedded under the skin. Some percutaneous electrodes only puncture the

skin, while others, called intramuscular electrodes, are imbedded into muscles. For years,

engineers have been developing surface EMG prosthetic controllers, while recording EMG

beneath the skin has been widely overlooked as a control method. ​The recording of EMG using

percutaneous electrodes is a valid technique for prosthetic control and has advantages over

surface EMG because it bypasses impedances on the surface of the skin, can be used for

proportional control of prosthetics, and allows prosthetics with multiple degrees of

freedom.

For decades, electrically powered hands and arms controlled by surface EMG have used

very simple control techniques. These techniques allow for prosthetic movement in only one

plane by measuring the difference in amplitude of two surface EMG signals from muscle pairs.
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This allows a prosthesis to be controlled in a positive or negative direction. In multiple cases,

research was conducted to design more complex EMG prosthetic control methods. Often times,

these methods involve using a user-trained algorithm to interpret signals from a larger number of

electrodes. However, this approach is heavily affected by the unreliability of surface electrodes.

Surface electrodes become unreliable due to changes in skin conditions, slight alterations in the

electrode placement, and liftoff of the electrode from the skin (Hahne et al.).

In one study, scientists present a percutaneous electrode in order to bypass the downsides

of the skin contact required for surface EMG. Their electrode, which was fabricated from

antimicrobial medical titanium, was implanted in four locations on the forearm and reached the

subcutaneous (beneath the skin) tissue of the test subject. The implanted electrodes were tested

in comparison to two common types of surface electrodes. The surface electrodes were placed

proximal and distal to the implanted electrodes, which minimized differences in EMG signals.

EMG signals were recorded by each type of electrode, processed using the same signal

amplification and filtering techniques, and evaluated in a number of categories to determine their

effectiveness (Hahne et al.).

The first category measured the electrical impedance of the electrode. According to the

study, the implanted electrode greatly outperformed the two surface electrodes, having a

substantially lower and very stable level of impedance. “Dry [surface] electrodes...had

impedance that was almost three orders of magnitude greater than the proposed implant and

resulted in very large noise levels”. Although proper filtering techniques of the EMG data may

have been able to reduce the noise level in EMG signals recorded from surface electrodes, the

impedance levels of percutaneous electrodes were still lower than filtered recordings from
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surface electrodes (Hahne et al.). The clarity of percutaneous EMG can allow for more acute

control of prosthetics over surface EMG.

The implanted electrodes were also tested in a control task in which a subject directed a

computer cursor and attempted to complete tasks. On the first day of testing, the control

algorithm was calibrated and the subject performed nearly equally for all tasks with surface and

percutaneous electrodes. However, on the second day of testing, when the algorithm was

recalibrated, performance of the surface electrodes decreased substantially while performance of

the implanted electrodes remained stable, indicating that the slight differences in skin condition

heavily affected the performance of surface electrodes (Hahne et al.). If the user of a surface

EMG prosthetic controller were to experience a similar change, he would be forced to recalibrate

his prosthetic before further use. Constant recalibration is a hassle for prosthetic users which can

be bypassed with the use of under the skin electrodes because they eliminate the possibility for

inaccuracies due to changes in skin condition.

Although the recording of EMG with percutaneous electrodes eliminates many downfalls

of surface EMG, in order for this type of control to be a viable alternative to surface EMG, it

must be able control more complex prosthetic movements. One important characteristic of an

advanced prosthetic is the ability to utilize proportional control, which allows users to control

their prosthetics with specific speeds and strengths.

In one study, a group of biomedical engineers investigated the usability of intramuscular

EMG to estimate the grasping force of a hand via proportional control. In their experiment, test

subjects used a hand grip dynamometer to measure the force they exerted with each hand

through a set of contractions. Simultaneously, intramuscular EMG was recorded. After the EMG
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signals were collected, processed, and analyzed, the researchers determined that there was an

exponential relationship between the grasping force of a hand and the EMG features recorded by

the intramuscular electrodes (Kamavuako et al., “Estimation of Grasping Force”). This means

that grasping force can be accurately predicted using intramuscular EMG, creating the possibility

for the proportional grip control of prosthetic limbs using percutaneous and intramuscular

electrodes. Additionally, the results of this experiment were obtained using only one

intramuscular electrode. Therefore, the use of intramuscular EMG to control grasping force has

the potential to be inexpensive in comparison to many current commercial prosthetic controllers

which must use multiple surface electrodes. Intramuscular EMG has the potential to be an

accessible and effective method of achieving prosthetic control with proportional grasping force,

making it a viable option in comparison to surface EMG.

In addition to proportional control, a desirable trait of an advanced prosthetic is the

ability to be controlled in multiple degrees of freedom (DOF). A DOF is a plane in which a

prosthetic can move. For example, a prosthetic arm that moves left and right horizontally has one

DOF. Giving the arm the ability to move up and down vertically adds a second DOF. Generally,

prosthetics that are flexible and lifelike have multiple controllable DOFs.

For percutaneous EMG to be a valid option in the future of prosthetics, it must be able to

control prosthetics with multiple DOFs. Several studies have been conducted to evaluate

intramuscular EMG for this type of control.

One study evaluated the usability of intramuscular EMG to control two DOFs using a

Fitts’ Law tracking test. In the test, intramuscular electrodes and surface electrodes were attached

to the subject and used to conduct trials in which the subject was required to move a virtual
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cursor to a randomly chosen target. Intramuscular EMG alone, surface EMG alone, or a

combination of both were used as control signals for the cursor (Kamavuako et al., “On the

usability of intramuscular EMG” 771-772).The recorded data was used to evaluate the

effectiveness of the control method in several categories: throughput, efficiency, overshoot,

average speed, and completion rate. Researchers discovered that “intramuscular EMG

significantly outperformed surface EMG by providing better path efficiency and less overshoot.”

The high score in path efficiency means that the subjects accurately placed the cursor and kept it

from drifting. The low value of overshoot suggested that the subjects stopped the cursor close to

the target more easily (Kamavuako et al., “On the usability of intramuscular EMG” 774). These

results indicate that a prosthetic user utilizing intramuscular EMG would have the ability to

precisely control movements of their prosthetic, thereby successfully completing more everyday

tasks. Because the precision intramuscular EMG was superior to that of surface EMG in this

study, intramuscular EMG has strong potential to be an accurate control method for a real

prosthetic, even having possible advantages to surface EMG.

A second study was conducted to determine if intramuscular EMG can be used to

improve classification of wrist and hand movements for up to three DOFs. In this study, test

subjects were fitted with six surface electrodes and six percutaneous intramuscular electrodes

and instructed to produce a sequence of contractions in one or two DOFs. The EMG data was

processed and then classified into output movements with two different types of classifiers:

single and parallel. A single classifier discriminates between motion types by recognizing

movements that are in one DOF, a second DOF, or a combination of both. In the parallel
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approach, multiple classifiers independently classify different DOFs simultaneously, so no single

classifier needs to recognize a movement in more than one DOF (Smith and Hargrove).

The scientists found that while intramuscular EMG performed similarly to surface EMG

when used for a single classifier, it produced a significant decrease in error when used for a

parallel classifier (Smith and Hargrove). This means that in real world application, a prosthetic

user utilizing a parallel classifier with implanted intramuscular electrodes would be able to

control his prosthetic without movement errors more frequently than if he were to use surface

electrodes to complete the same task.

Percutaneous EMG, although highly unused, is a viable option for prosthetic control and

in some situations, even superior to commonly used surface EMG techniques. Scientific studies

have proven that one main advantage of percutaneous EMG is that it bypasses the skin. Because

percutaneous electrodes are implanted instead of placed on top of the skin, they avoid issues like

electrode liftoff, changes in skin surface environment, and alterations in electrode placement. In

result, the EMG signal is more stable and clear than EMG recorded by surface electrodes.

Percutaneous EMG control systems may also lack the need to be recalibrated because of their

electrodes’ stable position. In addition to their advantages due to the nature of their placement,

percutaneous electrodes are a viable option for the advanced control of prosthetics in comparison

to surface electrodes. Intramuscular electrodes can be used for proportional control, like the grip

force of a hand. They have also proven to be an accurate and reliable control method for

prosthetics with multiple degrees of freedom. As with all invasive types of medicine, future

patients using percutaneous electrodes will need to consider risks of an implant, such as

infection. However, as percutaneous EMG becomes a more tested technique and implanted
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electrode technology continues to advance, the future of those with limb loss will only grow

brighter.
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Bibliography

1. Hahne, Janne M., et al. "A Novel Percutaneous Electrode Implant for Improving

Robustness in Advanced Myoelectric Control." Frontiers in Neuroscience,

vol. 10, 31 Mar. 2016

2. Kamavuako, Ernest Nlandu, et al. "Estimation of Grasping Force from Features of

Intramuscular EMG Signals with Mirrored Bilateral Training." Annals of

Biomedical Engineering, vol. 40, no. 3, Mar. 2012, pp. 648-56.

3. Kamavuako, Ernest Nlandu, et al. "On the usability of intramuscular EMG for

prosthetic control: A Fitts’ Law approach." Journal of Electromyography and

Kinesiology, 17 June 2014, pp. 770-77

4. Smith, Lauren H., and Levi J. Hargrove. "Comparison of surface and intramuscular

EMG pattern recognition for simultaneous wrist/hand motion classification."

35th Annual International Conference of the IEEE Engineering in Medicine

and Biology Society, 5 Feb. 2014, pp. 4223-26.

5. Ziegler-Graham K, MacKenzie EJ, Ephraim PL, Travison TG, Brookmeyer R.

“Estimating the Prevalence of Limb Loss in the United States: 2005 to 2050.”

Archives of Physical Medicine and Rehabilitation, 2008, 89(3):422-9.