Longitudinal high-density EMG classification: Case study in a glenohumeral TMR subject

Targeted muscle reinnervation (TMR) represents a breakthrough interface for prosthetic control in high-level upper-limb amputees. However, clinically, it is still limited to the direct motion-wise control restricted by the number of reinnervation sites. Pattern recognition may overcome this limitation. Previous studies on EMG classification in TMR patients experienced with myocontrol have shown greater accuracy when using high-density (HD) recordings compared to conventional single-channel derivations. This case study investigates the potential of HD-EMG classification longitudinally over a period of 17 months post-surgery in a glenohumeral amputee. Five experimental sessions, separated by approximately 3 months, were performed. They were timed during a standard rehabilitation protocol that included intensive physio- and occupational therapy, myosignal training, and routine use of the final myoprosthesis. The EMG signals recorded by HD-EMG grids were classified into 12 classes. The first sign of EMG activity was observed in the second experimental session. The classification accuracy over 12 classes was 76% in the third session and ~95% in the last two sessions. When using training and testing sets that were acquired with a 1-h time interval in between, a much lower accuracy (32%, Session 4) was obtained, which improved upon prosthesis usage (Session 5, 67%). The results document the improvement in EMG classification accuracy throughout the TMR-rehabilitation process.