Dataset Information

Factors associated with interest in novel interfaces for upper limb prosthesis control.

ABSTRACT:

Background

Surgically invasive interfaces for upper limb prosthesis control may allow users to operate advanced, multi-articulated devices. Given the potential medical risks of these invasive interfaces, it is important to understand what factors influence an individual's decision to try one.

Methods

We conducted an anonymous online survey of individuals with upper limb loss. A total of 232 participants provided personal information (such as age, amputation level, etc.) and rated how likely they would be to try noninvasive (myoelectric) and invasive (targeted muscle reinnervation, peripheral nerve interfaces, cortical interfaces) interfaces for prosthesis control. Bivariate relationships between interest in each interface and 16 personal descriptors were examined. Significant variables from the bivariate analyses were then entered into multiple logistic regression models to predict interest in each interface.

Results

While many of the bivariate relationships were significant, only a few variables remained significant in the regression models. The regression models showed that participants were more likely to be interested in all interfaces if they had unilateral limb loss (p ? 0.001, odds ratio ? 2.799). Participants were more likely to be interested in the three invasive interfaces if they were younger (p < 0.001, odds ratio ? 0.959) and had acquired limb loss (p ? 0.012, odds ratio ? 3.287). Participants who used a myoelectric device were more likely to be interested in myoelectric control than those who did not (p = 0.003, odds ratio = 24.958).

Conclusions

Novel prosthesis control interfaces may be accepted most readily by individuals who are young, have unilateral limb loss, and/or have acquired limb loss However, this analysis did not include all possible factors that may have influenced participant's opinions on the interfaces, so additional exploration is warranted.

SUBMITTER: Engdahl SM

PROVIDER: S-EPMC5540477 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Publications

Factors associated with interest in novel interfaces for upper limb prosthesis control.

Engdahl Susannah M SM Chestek Cynthia A CA Kelly Brian B Davis Alicia A Gates Deanna H DH

PloS one 20170802 8

<h4>Background</h4>Surgically invasive interfaces for upper limb prosthesis control may allow users to operate advanced, multi-articulated devices. Given the potential medical risks of these invasive interfaces, it is important to understand what factors influence an individual's decision to try one.<h4>Methods</h4>We conducted an anonymous online survey of individuals with upper limb loss. A total of 232 participants provided personal information (such as age, amputation level, etc.) and rated ...[more]

PMID: 28767716

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Project description:BackgroundPatient-reported outcomes (PROs) can be used to evaluate perceived capacity of an individual in executing tasks in a natural environment with their prosthetic device. According to the World Health Organization International Classification of Health, Functioning, and Disability (ICF) models, there may be specific factors of a person, factors of assistive prosthetic technology, or factors related to the health condition or body function that affect their functioning and disability. However, an understanding of factors affecting an upper limb prosthesis user's perception of their ability to execute tasks in a natural environment is not well established.ObjectiveTo use the ICF model to identify which health condition-related, body function, environmental, and personal factors influence activity as measured by perceived function in the upper limb prosthesis user population.DesignQuantitative clinical descriptive study.SettingClinical offices within outpatient private practice (removed for blinding).ParticipantsA sample of 101 participants with upper limb amputation who use a prosthetic device and were undergoing a prosthesis fitting process.InterventionsNot applicable.Main outcome measuresPROs on pain with/without a prosthesis, satisfaction, and perceived function derived from the Comprehensive Arm Prosthesis and Rehabilitation Outcomes Questionnaire.ResultsModel coefficients indicate that with a unit increase in satisfaction (p < .001) and pain (p = .031) scores (with higher pain scores signifying less pain), the mean of perceived function increases by 0.66 and 0.47 units, respectively. Conversely, for individuals with elbow disarticulation, transhumeral, shoulder disarticulation, and interscapulothoracic amputations, the mean of perceived function decreases by 22.02 units (p = .006).ConclusionsBased on our sample, perceived function is significantly associated with satisfaction, pain, and amputation level. These findings could potentially help to inform initial clinical approach and targeted outcomes for patients based on these factors.

Project description:BACKGROUND:Although electromyogram (EMG) pattern recognition (PR) for multifunctional upper limb prosthesis control has been reported for decades, the clinical benefits have rarely been examined. The study purposes were to: 1) compare self-report and performance outcomes of a transradial amputee immediately after training and one week after training of direct myoelectric control and EMG pattern recognition (PR) for a two-degree-of-freedom (DOF) prosthesis, and 2) examine the change in outcomes one week after pattern recognition training and the rate of skill acquisition in two subjects with transradial amputations. METHODS:In this cross-over study, participants were randomized to receive either PR control or direct control (DC) training of a 2 DOF myoelectric prosthesis first. Participants were 2 persons with traumatic transradial (TR) amputations who were 1 DOF myoelectric users. Outcomes, including measures of dexterity with and without cognitive load, activity performance, self-reported function, and prosthetic satisfaction were administered immediately and 1 week after training. Speed of skill acquisition was assessed hourly. One subject completed training under both PR control and DC conditions. Both subjects completed PR training and testing. Outcomes of test metrics were analyzed descriptively. RESULTS:Comparison of the two control strategies in one subject who completed training in both conditions showed better scores in 2 (18%) dexterity measures, 1 (50%) dexterity measure with cognitive load, and 1 (50%) self-report functional measure using DC, as compared to PR. Scores of all other metrics were comparable. Both subjects showed decline in dexterity after training. Findings related to rate of skill acquisition varied considerably by subject. CONCLUSIONS:Outcomes of PR and DC for operating a 2-DOF prosthesis in a single subject cross-over study were similar for 74% of metrics, and favored DC in 26% of metrics. The two subjects who completed PR training showed decline in dexterity one week after training ended. Findings related to rate of skill acquisition varied considerably by subject. This study, despite its small sample size, highlights a need for additional research quantifying the functional and clinical benefits of PR control for upper limb prostheses.

Project description:Objective.Electrical stimulation can induce sensation in the phantom limb of individuals with amputation. It is difficult to generalize existing findings as there are many approaches to delivering stimulation and to assessing the characteristics and benefits of sensation. Therefore, the goal of this systematic review was to explore the stimulation parameters that effectively elicited referred sensation, the qualities of elicited sensation, and how the utility of referred sensation was assessed.Approach.We searched PubMed, Web of Science, and Engineering Village through January of 2022 to identify relevant papers. We included papers which electrically induced referred sensation in individuals with limb loss and excluded papers that did not contain stimulation parameters or outcome measures pertaining to stimulation. We extracted information on participant demographics, stimulation approaches, and participant outcomes.Main results.After applying exclusion criteria, 49 papers were included covering nine stimulation methods. Amplitude was the most commonly adjusted parameter (n= 25), followed by frequency (n= 22), and pulse width (n= 15). Of the 63 reports of sensation quality, most reported feelings of pressure (n= 52), paresthesia (n= 48), or vibration (n= 40) while less than half (n= 29) reported a sense of position or movement. Most papers evaluated the functional benefits of sensation (n= 33) using force matching or object identification tasks, while fewer papers quantified subjective measures (n= 16) such as pain or embodiment. Only 15 studies (36%) observed percept intensity, quality, or location over multiple sessions.Significance.Most studies that measured functional performance demonstrated some benefit to providing participants with sensory feedback. However, few studies could experimentally manipulate sensation location or quality. Direct comparisons between studies were limited by variability in methodologies and outcome measures. As such, we offer recommendations to aid in more standardized reporting for future research.

Project description:Perceptual integration of a prosthesis into an amputee's body representation, that is, prosthesis embodiment, has been proposed to be a major goal of prosthetic treatment, potentially contributing to the user's satisfaction with the device. However, insufficient knowledge about individual or prosthetic factors associated with prosthesis embodiment challenges basic as well as rehabilitation research. In the present study, hierarchical multiple regression analyses on prosthesis embodiment-as assessed with the recently introduced Prosthesis Embodiment Scale-were applied to the survey data of a large sample of prosthesis-using lower limb amputees, entering relevant objective-descriptive (i.e., unbiased characteristics of the amputation or the prosthesis) and subjective-evaluative variables (i.e., the amputee's perceptions related to the amputation or the prosthesis) as first- or second-level regressors, respectively. Significant regressors identified in these analyses together explained R 2 = 36.3% of prosthesis embodiment variance in the present sample, with a lower level of amputation, less intense residual limb pain, more realistic visual appearance of the device, higher prosthetic mobility, and more positive valence of prosthesis-induced residual limb stimulations representing significantly associated factors. Using the identical set of regressors hierarchically complemented by prosthesis embodiment on measures of prosthetic satisfaction-as assessed with the Trinity Amputation and Prosthesis Experience Scales-revealed that prosthesis embodiment was significantly and positively associated with aesthetic as well as functional prosthesis satisfaction. These findings emphasize the importance of psychological factors for the integration of a prosthesis into the amputee's body representation, which itself represents a crucial factor associated with prosthesis satisfaction. The results might have important implications for future prosthetic treatment; however, replication of the findings in an independent sample is required, as well as sophisticated experimental designs in order to elucidate the causality of effects.

Dataset Information

Factors associated with interest in novel interfaces for upper limb prosthesis control.

Background

Methods

Results

Conclusions

Publications

Factors associated with interest in novel interfaces for upper limb prosthesis control.

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