Creating a standardized, quantitative training protocol for upper limb bypass prostheses

Bloomer, Conor; Wang, Xin Wei; Kontson, Kimberly

doi:10.15761/pmrr.1000191

Cited by 10 publications

(14 citation statements)

References 28 publications

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“…However, no study on the BBT has shown the average age prosthetic users of BBT for. Previous studies have used an average of 25-30 blocks when assessing prosthetic control skills with the BBT [31,32]. In this study, the average P2 score for each group was 25-28 blocks with and without intervention, which was similar to the average score in previous papers.…”

Section: Vr Effect Depending On Task Difficultysupporting

confidence: 79%

Virtual reality-based action observation facilitates the acquisition of body-powered prosthetic control skills

Yoshimura

Kurumadani

Hirata

et al. 2020

J NeuroEngineering Rehabil

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Background: Regular body-powered (BP) prosthesis training facilitates the acquisition of skills through repeated practice but requires adequate time and motivation. Therefore, auxiliary tools such as indirect training may improve the training experience and speed of skill acquisition. In this study, we examined the effects of action observation (AO) using virtual reality (VR) as an auxiliary tool. We used two modalities during AO: three-dimensional (3D) VR and twodimensional (2D) computer tablet devices (Tablet). Each modality was tested from first-and third-person perspectives. Methods: We studied 40 healthy right-handed participants wearing a BP prosthesis simulator on their non-dominant hands. The participants were divided into five groups based on combinations of the different modalities and perspectives: first-person perspective on VR (VR1), third-person perspective on VR (VR3), first-person perspective on a tablet (Tablet1), third-person perspective on a tablet (Tablet3), and a control group (Control). The intervention groups observed and imitated the video image of prosthesis operation for 10 min in each of two sessions. We evaluated the level of immersion during AO using the visual analogue scale. Prosthetic control skills were evaluated using the Box and Block Test (BBT) and a bowknot task (BKT). Results: In the BBT, there were no significant differences in the amount of change in the skills between the five groups. In contrast, the relative changes in the BKT prosthetic control skills in VR1 (p < 0.001, d = 3.09) and VR3 (p < 0.001, d = 2.16) were significantly higher than those in the control group. Additionally, the immersion scores of VR1 (p < 0.05, d = 1.45) and VR3 (p < 0.05, d = 1.18) were higher than those of Tablet3. There was a significant negative correlation between the immersion scores and the relative change in the BKT scores (Spearman's r s = − 0.47, p < 0.01). Conclusions: Using the BKT of bilateral manual dexterity, VR-based AO significantly improved short-term prosthetic control acquisition. Additionally, it appeared that the higher the immersion score was, the shorter the execution time of the BKT task. Our findings suggest that VR-based AO training may be effective in acquiring bilateral BP prosthetic control, which requires more 3D-based operation.

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Section: Vr Effect Depending On Task Difficultysupporting

confidence: 79%

Virtual reality-based action observation facilitates the acquisition of body-powered prosthetic control skills

Yoshimura

Kurumadani

Hirata

et al. 2020

J NeuroEngineering Rehabil

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“…Participants completed the training protocol outlined by Bloomer et al. 24 The protocol required participants to complete 10 sessions with a duration of 2 hours each sessions to balance the amount of time typically provided to train bypass prosthesis users on devices (up to several weeks) 7 , 19 and the time commitment of the study participants. Training activities focused on basic object manipulation tasks and activities of daily living while emphasizing thoughtful planning before attempting a task, such as prepositioning of the terminal device specifically for the body-powered device or determining the appropriate grip to use for the DEKA arm.…”

Section: Methodsmentioning

confidence: 99%

Comparison of DEKA Arm and Body-Powered Upper Limb Prosthesis Joint Kinematics

Bloomer

Kontson

2020

Archives of Rehabilitation Research and Clinical Translation

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Objectives To study the effects of advancements in upper-limb prosthesis technology on the user through biomechanical analyses at the joint level to quantitatively examine movement differences of individuals using an advanced upper-limb device, the DEKA Arm, and a conventional device, a body-powered Hosmer hook. Design Clinical measurement. Setting Laboratories at the United States Food and Drug Administration. Participants Convenience sample of participants (N=14) with no upper limb disability or impairment. Interventions All participants were trained on either an upper limb body-powered (n=6) or DEKA Arm (n=8) bypass device. Main Outcome Measures Participants completed the Jebsen-Taylor Hand Function Test (JHFT) and targeted Box and Blocks Test within a motion capture framework. Task completion times and joint angle trajectories for each degree of freedom of the right elbow, right shoulder, and torso were collected and analyzed for range of motion, mean angle, maximum angle, and angle path length during each task. Results Significant differences between devices were observed across metrics in at least one task for each degree of freedom. Completion times were significantly higher for DEKA users (eg, 30.51±19.29s vs 9.30±1.44s) for JHFT–simulated feeding. Some kinematic measures, such as angle path length, were significantly lower in DEKA users, with the greatest difference in the right elbow flexion path length during JHFT–Page Turning (0.29±0.14 units vs 0.11±0.04 units). Conclusions Results from this work elucidate the effect of the device on the user’s movement approach and performance, as well as emphasizing the importance of capturing movement quality into the assessment of function for advanced prosthetic technology to fully understand and evaluate potential benefits.

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“…However, there is no study showing the average age of BBT for prosthetic users. Previous studies have reported an average of 25-30 blocks in assessing prosthetic control skills using BBT [22,23]. In this study, the average score of each group in Post2 is 25-28 blocks.…”

Section: Vr Effect Depending On Task Difficultymentioning

confidence: 81%

Virtual reality-based action observation facilitates acquisition of body-powered prosthetic control skills

Yoshimura¹,

Kurumadani²,

Hirata³

et al. 2020

Preprint

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Background Regular body-powered prosthesis (bp-prosthesis) training often facilitates acquisition of skills through repeated practice but requires adequate time and motivation. Therefore, if there are auxiliary tools, such as indirect training, skill acquisition may be easy. In this study, we examined the effects of action observation (AO) using virtual reality (VR) as an auxiliary tool. We examined two different modalities during AO, VR and tablet device (Tab), and two perspectives, first- and third-person perspectives. This study aimed to examine whether AO training using VR is effective in acquiring bp-prosthetic control skills in the short term. Methods Forty healthy right-handed participants simulated bp-prosthesis with the non-dominant hand. They were divided into five groups with different interventions and displays for AO: first-person perspective on VR (VR1st), third-person perspective on VR (VR3rd), first-person perspective on Tab (Tab1st), third-person perspective on Tab (Tab3rd), and control group (Con) without AO. Participants of VR1st, VR3rd, Tab1st, and Tab3rd observed the video image of experts operating prosthesis twice, 10 min each time. We evaluated the immersion during the video observation using the Visual Analog Scale. Prosthetic control skills were evaluated using the box and block test (BBT) and bowknot task (BKT). Results In BBT, no significant enhancements of prosthetic control skills between groups were found. In contrast, the BKT change rates of prosthetic control skills in VR1st and VR3rd were significantly higher than those in Con (p < 0.001). Additionally, immersion scores of VR1st and VR3rd were higher than those of Tab3rd (p < 0.05), and there was a significant negative correlation between immersion and BKT change rate (Spearman’s rs = -0.47, p < 0.01). Conclusions In BKT (bilateral manual dexterity), VR video viewing led to significantly better short-term prosthetic control acqusition than Con. Additionally, it was suggested that the higher the immersion, the shorter the BKT task execution time. Our findings suggest that VR-based AO training is effective in acquiring bp-prosthetic control in the short term. Especially, it is effective for bilateral prosthetic control, which is necessary in the daily life of upper limb amputees.

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Creating a standardized, quantitative training protocol for upper limb bypass prostheses

Cited by 10 publications

References 28 publications

Virtual reality-based action observation facilitates the acquisition of body-powered prosthetic control skills

Virtual reality-based action observation facilitates the acquisition of body-powered prosthetic control skills

Comparison of DEKA Arm and Body-Powered Upper Limb Prosthesis Joint Kinematics

Virtual reality-based action observation facilitates acquisition of body-powered prosthetic control skills

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