The goal of user-centered development (UCD) is an active involvement of the user for a clear understanding of the users' needs. In the context of rehabilitation engineering it is essential to integrate the users' needs into the development methodology. In fact the use or disclaim of assistive device depends on good comfort and satisfaction during application. Especially prostheses are developed to improve amputees' quality of life up to live independently again. UCD can improve integrating the amputees' needs into the prosthesis' properties. For a more detailed view of the prosthesis-users' needs we developed a questionnaire and collected data from patients regarding their needs using lower limb prostheses. 88 items, describing satisfaction, usability, appearance, functionality and handling of the prosthesis in different motor situations, were generated. Among 65 participants, 29 transfemoral amputees and experienced prosthesis users completed the questionnaire. The results indicate a lack of satisfaction with the prosthesis shaft as well as with different motor functions. Furthermore, the majority feels socially restricted and is dissatisfied with their appearance in public. While the latter is significantly negative correlated with feelings of social restriction, problems during changing gait speed are significantly negative correlated with feelings of certainty and stability during spontaneous movements. Although prostheses are developed to help to improve amputees' quality of life, the lack in different motor-and social-issues are noticeable. This indicates that the enhancement of changing gait speed in prostheses may help amputees to feel more certain and natural during walking. From an amputee's point of view, this could be one important predictor for being more satisfied and a first step for being more independent in life in general. With this first step of UCD, important information for the design of prosthesis in future has been generated.
Feelings of unrealistic body parts are related to deficits in human information processing and can occur as a part of phantom sensations after amputation [8]. Experimentally induced sensoric illusions like rubber hand illusion (RHI) [1] may help to understand basic information processing and could give new ideas for treatment or the rehabilitation process. Factors that are related to modulate sensoric illusions during movement may help to develop new intervention strategies in the rehabilitation of illusory symptoms. The goal of this study was to review the factors affecting persistence of the RHI effect during movement. We selected 13 keywords and searched in the following www.dimdi.de data bases (CCTR93, CDAR94, CDSR93, DAHTA, DAHTA, EA08, ED93, EM00, EM47, HG05, KP05, KR03, ME00, ME60, PI67, PY81, TV01, TVPP). A total of 160 articles were found. Duplicates were removed and the remaining list was filtered with the objective to explore the influence of active or passive movement during experimentally induced RHI. Then we identified six articles which experimentally examined persistence of RHI during active or passive movements. Results indicate that RHI are maintained during active or passive movements due to visual and temporal congruency. During active movements the RHI is more stable or global than in passive movements or during tactile stimulation. Factores like visual and temporal congruency are related to maintain RHI and are discussed in the rehabilitation of phantom sensations regarding new innovations in the design of prosthetics IntroductionAfter an amputation, feelings of unrealistic body parts are related to deficits in human information processing and can occur as a part of phantom sensations [8]. Those phantom sensations after an amputation are able to lead to feelings of pain which may be localized in a limb that no longer exists. All of these symptoms suggest disturbances in the experience of the body image/body scheme or in general a potential harm to the body matrix concept [24]. The rubber hand illusionBotvinick and Cohen [2] showed that the body image/scheme can experimentally be manipulated in healthy volunteers. In this standard paradigm a subject sees a visibly rubber hand being brushed while the real hidden hand of the subject is also synchronously brushed. After a certain time (15 seconds to 10 minutes) this process induces the feeling of ownership of an artificial limb (the rubber hand). Studies demonstrated that on average 25% of the participants do not respond to items that indicate this kind of illusory embodiment [10,6,5,4]. The cause and stability of this effect in responding subjects is attributed to multisensory integration between visual, tactile and proprioceptive information (see Image 1).Also a proprioceptive recalibration towards the rubber hand can be measured. This proprioceptive drift is being measured after the evoking of the illusion. The subject is asked to show the position of his/her real hand. In case of a successful illusion, subjects tend to show the po...
Introduction: Feelings of unrealistic body parts are related to deficits in human information processing and can occur as a part of schizophrenic disorders or phantom sensations after amputation (Koide, 2008; Goller, in press). Experimentally induced sensoric illusions like rubber hand illusion (RHI) (Botvinik & Cohen, 1998) may help to understand basic information processing and could give new ideas for treatment or the rehabilitation process. Objectives: Factors that are related to modulate sensoric illusions during movement may help to develop new intervention strategies in the rehabilitation of illusory symptoms. Aims: The goal of this study was to review the factors affecting persistence of the RHI effect during movement. Methods: We selected 13 keywords and searched in the following www.dimdi.de data bases (CCTR93,
BackgroundIn product development for lower limb prosthetic devices, a set of special criteria needs to be met. Prosthetic devices have a direct impact on the rehabilitation process after an amputation with both perceived technological and psychological aspects playing an important role. However, available psychometric questionnaires fail to consider the important links between these two dimensions. In this article a probabilistic latent trait model is proposed with seven technical and psychological factors which measure satisfaction with the prosthesis. The results of a first study are used to determine the basic parameters of the statistical model. These distributions represent hypotheses about factor loadings between manifest items and latent factors of the proposed psychometric questionnaire.MethodsA study was conducted and analyzed to form hypotheses for the prior distributions of the questionnaire’s measurement model. An expert agreement study conducted on 22 experts was used to determine the prior distribution of item-factor loadings in the model.ResultsModel parameters that had to be specified as part of the measurement model were informed prior distributions on the item-factor loadings. For the current 70 items in the questionnaire, each factor loading was set to represent the certainty with which experts had assigned the items to their respective factors. Considering only the measurement model and not the structural model of the questionnaire, 70 out of 217 informed prior distributions on parameters were set.ConclusionThe use of preliminary studies to set prior distributions in latent trait models, while being a relatively new approach in psychological research, provides helpful information towards the design of a seven factor questionnaire that means to identify relations between technical and psychological factors in prosthetic product design and rehabilitation medicine.
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