Competitive motivation increased home use and improved prosthesis self-perception after Cybathlon 2020 for neuromusculoskeletal prosthesis user

Abstract

Background Assistive technologies, such as arm prostheses, are intended to improve the quality of life of individuals with physical disabilities. However, certain training and learning is usually required from the user to make these technologies more effective. Moreover, some people can be encouraged to train more through competitive motivation. Methods In this study, we investigated if the training for and participation in a competitive event (Cybathlon 2020) could promote behavioral changes in an individual with upper limb amputation (the pilot). We defined behavioral changes as the active time while his prosthesis was actuated, ratio of opposing and simultaneous movements, and the pilot’s ability to finely modulate his movement speeds. The investigation was based on extensive home-use data from the period before, during and after the Cybathlon 2020 competition. Results Relevant behavioral changes were found from both quantitative and qualitative analyses. The pilot’s home use of his prosthesis nearly doubled in the period before the Cybathlon, and remained 66% higher than baseline after the competition. Moreover, he improved his speed modulation when controlling his prosthesis, and he learned and routinely operated new movements in the prosthesis (wrist rotation) at home. Additionally, as confirmed by semi-structured interviews, his self-perception of the prosthetic arm and its functionality also improved. Conclusions An event like the Cybathlon may indeed promote behavioral changes in how competitive individuals with amputation use their prostheses. Provided that the prosthesis is suitable in terms of form and function for both competition and at-home daily use, daily activities can become opportunities for training, which in turn can improve prosthesis function and create further opportunities for daily use. Moreover, these changes appeared to remain even well after the event, albeit relevant only for individuals who continue using the technology employed in the competition.

Improved control of a prosthetic limb by surgically creating electro-neuromuscular constructs with implanted electrodes

“…Because of constraints on the patient’s availability, we performed only one set of functional tests during each follow-up. Therefore, another limitation of our study was that we did not disentangle the separate contributions to improvement of (i) electrode type (surface versus implanted), (ii) intuitiveness of control (native residual muscles versus surgically reconstructed myoelectric sites), and (iii) potential learning effects ( 21 ). The SHAP score but not the ACMC score showed improvement early after intervention when the control scheme was nonintuitive, and both scores showed improvement later at week 59, when the control was intuitive using the new surgically reconstructed myoelectric sites and the patient was more experienced.…”

“…During the time of this 2-year study, the patient first used a prosthesis, allowing for a DoF of 1.5 (hand opening/closing and elbow lock/unlock) for daily home use. At week 65, the patient was fitted with an additional DoF prosthesis (pronation/supination) ( 21 ). At 181 weeks after the surgery, the patient was also provided with an active elbow, allowing him to control a total of 3 DoFs for daily home use.…”

Intuitive control of additional prosthetic joints via electro-neuromuscular constructs improves functional and disability outcomes during home use—a case study

“…The embedded system did not feature a real-time clock and only logged a flag variable signaling every system reboot. Based on these reboot flags and the logging frequency we were able to extract usage information of known duration, hereafter defined as a 'session' [38]. As we were primarily interested in how the prosthesis is used during continued operation in daily life, we omitted any session below 30 min usage.…”

Deployment of Machine Learning Algorithms on Resource-Constrained Hardware Platforms for Prosthetics

“…In the context of prosthetics, minimizing power consumption in self-contained prostheses is crucial to ensure functionality and independence in everyday life. This significance arises from the fact that active prosthetic users typically engage with their prostheses for an average of 11 hours daily, with merely 7 minutes dedicated to actual hand movement [62]. Even with periods of heightened energy consumption during active usage, the prosthetic system idles for a staggering 99% of the usage time, revealing an immense potential for power consumption savings.…”