Huinink, L.H.B. (2014) Learning to use an upper limb prosthesis: The development of motor skills in novice body-powered prosthesis users over time. thesis, Human Movement Sciences.
Full text available on request.Abstract
Background: A recent study examined how people learn to use a myoelectric prosthesis (Bouwsema et al., 2014). With this knowledge a foundation was laid for an evidence-based training program for myoelectric prostheses. However, body-powered prostheses differ from myoelectric prostheses, regarding the control regime and the feedback provided from the prosthesis. Due to the cable-based control of the body-powered prosthesis via body-movements, more proprioceptive feedback is provided. These differences might have consequences for how body-powered prostheses need to be trained. Aim: The aim of this study is to describe the learning processes and performances over time of novice body-powered prosthesis users during practice of goal-directed tasks. Method: Thirty able-bodied participants were randomly assigned to one of four experimental groups, and practiced with a body-powered prosthesis simulator, equipped with a voluntary closing TRS hook, for five sessions during a period of two weeks. Groups had to perform either indirect grasping (IG), handing over the object from the sound hand, direct grasping (DG), fixation (FIX) or a combination of all three tasks (COM). Prior to the learning sessions the Southampton Hand Assessment Procedure (SHAP) was performed, as well as during the posttest, 2-weeks retention and 3-months retention test. During grasping tasks deformable objects with a different compliance were used which had to be manipulated. Movement kinematics were examined, as well as the compression of the object. Results: All four experimental groups improved on the SHAP over training. Interestingly there were no significant differences between groups. Total reach time and hand closing time decreased during the training sessions. Importantly, the IG group showed a shorter time in which the hook was fully open (i.e. the plateau time) compared with the DG and COM group. The data showed a trend in that the IG group also showed a faster performance in reach time and hand closing time, whereas DG showed a higher peak velocity of hand closing. In general, when object rigidity decreased, overall movement times increased. As expected, low-resistance objects were more compressed than high-resistance objects. It was remarkable that compression did not change over the learning sessions. Discussion & Conclusion: The data on the reaching and grasping profile clearly showed that motor skills of novice body-powered prosthetic users improved during a two-week training period. Interestingly, the IG group, which handed over the object from the sound hand, had shorter plateau times than the other groups. We hypothesized that proprioception of the sound hand might have helped perceiving object properties. Comparing these data with improvement over training in myoelectric prostheses showed that overall movement times with a body-powered prosthesis were faster.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Bongers, R.M. |
| Faculty: | Medical Sciences |
| Date Deposited: | 12 Apr 2022 09:18 |
| Last Modified: | 12 Apr 2022 09:18 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3091 |
Actions (login required)
 |
View Item |