Prosthesis embodiment and attenuation of prosthetic touch in upper limb amputees – A proof-of-concept study

Fritsch, Antonia; Lenggenhager, Bigna; Bekrater-Bodmann, Robin

doi:10.1016/j.concog.2020.103073

Cited by 16 publications

(14 citation statements)

References 81 publications

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“…They used four categories (quantity of use, functional use, aesthetic use, and psychological use) to infer a bodily integration score. Furthermore, Bekrater-Bodmann and colleagues recently developed and validated the Prosthesis Embodiment Scale for Lower Limb Amputees (PEmbS-LLA) [ 59 ], as well as the Prosthesis Embodiment Scale for Upper Limb Amputees (PEmbS-ULA) [ 96 ], both focus on explicit ownership, explicit agency, and anatomical plausibility.…”

Section: Resultsmentioning

confidence: 99%

“…Sensory attenuation can be assessed by a force-matching task, where participants receive either a self-administered or external, yet known, force stimulus and then they are subsequently prompted to generate the same perceived force by e.g., pressing their index finger against a force sensor. Fritsch et al showed that sensory attenuation can also be elicited in upper-limb prosthetic users when they touch their foot with their prosthesis [ 96 ]. They further reported increased sensory attenuation with higher self-reported explicit ownership over the prosthesis, thereby positioning sensory attenuation as another implicit ownership measure.…”

Section: Resultsmentioning

confidence: 99%

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Prosthetic embodiment: systematic review on definitions, measures, and experimental paradigms

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Lendaro

Ortiz-Catalán

2022

J NeuroEngineering Rehabil

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The term embodiment has become omnipresent within prosthetics research and is often used as a metric of the progress made in prosthetic technologies, as well as a hallmark for user acceptance. However, despite the frequent use of the term, the concept of prosthetic embodiment is often left undefined or described incongruently, sometimes even within the same article. This terminological ambiguity complicates the comparison of studies using embodiment as a metric of success, which in turn hinders the advancement of prosthetics research. To resolve these terminological ambiguities, we systematically reviewed the used definitions of embodiment in the prosthetics literature. We performed a thematic analysis of the definitions and found that embodiment is often conceptualized in either of two frameworks based on body representations or experimental phenomenology. We concluded that treating prosthetic embodiment within an experimental phenomenological framework as the combination of ownership and agency allows for embodiment to be a quantifiable metric for use in translational research. To provide a common reference and guidance on how to best assess ownership and agency, we conducted a second systematic review, analyzing experiments and measures involving ownership and agency. Together, we highlight a pragmatic definition of prosthetic embodiment as the combination of ownership and agency, and in an accompanying article, we provide a perspective on a multi-dimensional framework for prosthetic embodiment. Here, we concluded by providing recommendations on metrics that allow for outcome comparisons between studies, thereby creating a common reference for further discussions within prosthetics research.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Prosthetic embodiment: systematic review on definitions, measures, and experimental paradigms

Zbinden

Lendaro

Ortiz-Catalán

2022

J NeuroEngineering Rehabil

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“…Not only may the control priorities differ, but the perception of the autonomous system may also be different. Indeed, the embodiment of a prosthesis is a relevant parameter of its acceptance and use (Fritsch et al, 2021). Therefore, it would be interesting to complement the quantitative outcomes measured in this study with the effect that the shared control modality might have on the prosthesis's embodiment in the user's selfrepresentation.…”

Section: Discussionmentioning

confidence: 99%

Impact of Shared Control Modalities on Performance and Usability of Semi-autonomous Prostheses

et al. 2021

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Semi-autonomous (SA) control of upper-limb prostheses can improve the performance and decrease the cognitive burden of a user. In this approach, a prosthesis is equipped with additional sensors (e.g., computer vision) that provide contextual information and enable the system to accomplish some tasks automatically. Autonomous control is fused with a volitional input of a user to compute the commands that are sent to the prosthesis. Although several promising prototypes demonstrating the potential of this approach have been presented, methods to integrate the two control streams (i.e., autonomous and volitional) have not been systematically investigated. In the present study, we implemented three shared control modalities (i.e., sequential, simultaneous, and continuous) and compared their performance, as well as the cognitive and physical burdens imposed on the user. In the sequential approach, the volitional input disabled the autonomous control. In the simultaneous approach, the volitional input to a specific degree of freedom (DoF) activated autonomous control of other DoFs, whereas in the continuous approach, autonomous control was always active except for the DoFs controlled by the user. The experiment was conducted in ten able-bodied subjects, and these subjects used an SA prosthesis to perform reach-and-grasp tasks while reacting to audio cues (dual tasking). The results demonstrated that, compared to the manual baseline (volitional control only), all three SA modalities accomplished the task in a shorter time and resulted in less volitional control input. The simultaneous SA modality performed worse than the sequential and continuous SA approaches. When systematic errors were introduced in the autonomous controller to generate a mismatch between the goals of the user and controller, the performance of SA modalities substantially decreased, even below the manual baseline. The sequential SA scheme was the least impacted one in terms of errors. The present study demonstrates that a specific approach for integrating volitional and autonomous control is indeed an important factor that significantly affects the performance and physical and cognitive load, and therefore these should be considered when designing SA prostheses.

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“…In accordance to the published guidelines (Bekrater-Bodmann, 2020), the total score of the PEmbS-LLA, representing an overall measure of prosthesis embodiment, was calculated by averaging all valid items (up to one missing item was allowed in the present study, which was the case in n = 4 participants), ranging from -3 to +3, with higher scores indicating higher prosthesis embodiment. The instrument has previously been shown to have good to excellent reliability (Bekrater-Bodmann, 2020), and meaningful associations to individual and prosthesis characteristics, prosthesis satisfaction (Bekrater-Bodmann, 2021), and implicit behavioral measures (Fritsch et al, 2021) suggest validity of the instrument.…”

Section: Prosthesis Embodimentmentioning

confidence: 99%

“…Prosthesis embodiment has been related to several beneficial outcomes of prosthesis use, such as a more stabilized body posture (Imaizumi, Asai, & Koyama, 2016), a better representation of the nearby space of action (Gouzien et al, 2017), higher prosthesis satisfaction (Bekrater-Bodmann, 2021), or less severe phantom limb pain (Bekrater-Bodmann, Reinhard, Diers, Fuchs, & Flor, 2021;Kern, Busch, Rockland, Kohl, & Birklein, 2009). The majority of amputees report prosthesis embodiment, albeit the inter-individual variability is high (Bekrater-Bodmann, 2020;Fritsch, Lenggenhager, & Bekrater-Bodmann, 2021). Recent studies identified several predictors of prosthesis embodiment, which can be summarized in terms of corporeal-structural characteristics of the user (e.g., the level of amputation), sensorimotor experiences and capabilities (e.g., time since amputation and prosthesis use frequency), and properties of the prosthetic device (Bekrater-Bodmann, 2021;Bekrater-Bodmann et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

Mind over matter: Perceived phantom/prosthesis co-location contributes to prosthesis embodiment in lower limb amputees

Bekrater-Bodmann

2022

Consciousness and Cognition

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Prosthesis embodiment (PEmb) -the cognitive integration of a prosthesis into an amputees' body representation -has been identified as key feature of prosthetic rehabilitation. However, the underlying mechanisms remain unclear. There is reason to assume that phantom limbs that are experienced as part of the bodily self (phantom self-consciousness, PSC) can affect PEmb, but only if the phantom and the prosthesis can be brought into perceived co-location (phantom prosthesis tolerance, PPT). In the present study, phantom-prosthesis interactions were examined in lower limb amputees, and a PPT component was psychometrically extracted. Mediation analysis revealed an indirect-only effect, where the relationship between PSC and PEmb was mediated by PPT, indicating that phantom limbs can transfer their immanent vividness to the artificial limb. Subsequent analyses suggested that this effect can compensate for negative consequences that arise from phantom limb awareness. These results shape theoretical considerations about the cognitive processes contributing to the bodily self.

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Prosthesis embodiment and attenuation of prosthetic touch in upper limb amputees – A proof-of-concept study

Cited by 16 publications

References 81 publications

Prosthetic embodiment: systematic review on definitions, measures, and experimental paradigms

Prosthetic embodiment: systematic review on definitions, measures, and experimental paradigms

Impact of Shared Control Modalities on Performance and Usability of Semi-autonomous Prostheses

Mind over matter: Perceived phantom/prosthesis co-location contributes to prosthesis embodiment in lower limb amputees

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