Save that arm

Jones, L. E.; Davidson, Judith

doi:10.3109/03093649909071611

Cited by 103 publications

(43 citation statements)

References 6 publications

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“…While tremendous resources are dedicated to aiding 1-handed populations through the development of sophisticated prosthetic limbs ( Kuiken et al, 2009 ), a relatively large number of the individuals do not use them and prefer to carry out daily activities with their intact hand ( Jang et al, 2011 ; Østlie et al, 2012 ). Clinicians are aware that different individuals adapt to limblessness in varying ways–with some relying on the intact limb ( Jones and Davidson, 1999 ) and others showing remarkable ability with their residual limb or a prosthetic limb ( Smurr et al, 2008 ; Jang et al, 2011 ). Surprisingly, however, to our knowledge there has been no previous empirical study of the range of adaptive motor behaviours taken in 1-handed individuals in their natural environment ( Lindner et al, 2010 ).…”

Section: Discussionmentioning

confidence: 99%

Deprivation-related and use-dependent plasticity go hand in hand

Makin

Cramer

Scholz

et al. 2013

eLife

108

168

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Arm-amputation involves two powerful drivers for brain plasticity—sensory deprivation and altered use. However, research has largely focused on sensory deprivation and maladaptive change. Here we show that adaptive patterns of limb usage after amputation drive cortical plasticity. We report that individuals with congenital or acquired limb-absence vary in whether they preferentially use their intact hand or residual arm in daily activities. Using fMRI, we show that the deprived sensorimotor cortex is employed by whichever limb individuals are over-using. Individuals from either group that rely more on their intact hands (and report less frequent residual arm usage) showed increased intact hand representation in the deprived cortex, and increased white matter fractional anisotropy underlying the deprived cortex, irrespective of the age at which deprivation occurred. Our results demonstrate how experience-driven plasticity in the human brain can transcend boundaries that have been thought to limit reorganisation after sensory deprivation in adults.DOI: http://dx.doi.org/10.7554/eLife.01273.001

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Section: Discussionmentioning

confidence: 99%

Deprivation-related and use-dependent plasticity go hand in hand

Makin

Cramer

Scholz

et al. 2013

eLife

108

168

View full text Add to dashboard Cite

show abstract

“…Evaluating the impact of wearing a prosthetic arm on overuse and asymmetry may require load and hazard stratification. There are studies that discuss overuse and asymmetry consequences [ 16 , 17 ], also in the context of wearing a prosthetic arm [ 18 – 22 ]. They do not address the fact that for very intense work, it may make a significant difference for that individual whether a prosthesis is worn that actually supports intense work, and whether the individual trains to keep fit for that job.…”

Section: Introductionmentioning

confidence: 99%

Case-study of a user-driven prosthetic arm design: bionic hand versus customized body-powered technology in a highly demanding work environment

Schweitzer

Thali

Egger

2018

J NeuroEngineering Rehabil

112

124

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BackgroundProsthetic arm research predominantly focuses on “bionic” but not body-powered arms. However, any research orientation along user needs requires sufficiently precise workplace specifications and sufficiently hard testing. Forensic medicine is a demanding environment, also physically, also for non-disabled people, on several dimensions (e.g., distances, weights, size, temperature, time).MethodsAs unilateral below elbow amputee user, the first author is in a unique position to provide direct comparison of a “bionic” myoelectric iLimb Revolution (Touch Bionics) and a customized body-powered arm which contains a number of new developments initiated or developed by the user: (1) quick lock steel wrist unit; (2) cable mount modification; (3) cast shape modeled shoulder anchor; (4) suspension with a soft double layer liner (Ohio Willowwood) and tube gauze (Molnlycke) combination. The iLimb is mounted on an epoxy socket; a lanyard fixed liner (Ohio Willowwood) contains magnetic electrodes (Liberating Technologies). An on the job usage of five years was supplemented with dedicated and focused intensive two-week use tests at work for both systems.ResultsThe side-by-side comparison showed that the customized body-powered arm provides reliable, comfortable, effective, powerful as well as subtle service with minimal maintenance; most notably, grip reliability, grip force regulation, grip performance, center of balance, component wear down, sweat/temperature independence and skin state are good whereas the iLimb system exhibited a number of relevant serious constraints.ConclusionsResearch and development of functional prostheses may want to focus on body-powered technology as it already performs on manually demanding and heavy jobs whereas eliminating myoelectric technology’s constraints seems out of reach. Relevant testing could be developed to help expediting this. This is relevant as Swiss disability insurance specifically supports prostheses that enable actual work integration. Myoelectric and cosmetic arm improvement may benefit from a less forgiving focus on perfecting anthropomorphic appearance.

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“…For example, individuals with transradial amputation are proficient at compensating for the missing DoFs in their hand prosthesis by changing the motions of their arms and body 6 7 . However, these compensatory movements (CM) often put greater forces on the anatomy and may result in residual limb pain, secondary musculoskeletal complaints and overuse syndromes 8 9 10 .…”

mentioning

confidence: 99%

Independent Long Fingers are not Essential for a Grasping Hand

Montagnani

Controzzi

Cipriani

2016

Sci Rep

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The human hand is a complex integrated system with motor and sensory components that provides individuals with high functionality and elegant behaviour. In direct connection with the brain, the hand is capable of performing countless actions ranging from fine digit manipulation to the handling of heavy objects. However the question of which movements mostly contribute to the manipulation skills of the hand, and thus should be included in prosthetic hands, is yet to be answered. Building from our previous work, and assuming that a hand with independent long fingers allowed performance comparable to a hand with coupled fingers, here we explored the actual contribution of independent fingers while performing activities of daily living using custom built orthoses. Our findings show that, when an opposable thumb is present, independent long fingers provide a measureable advantage in performing activities of daily living only when precision grasps are involved. In addition, the results suggest that the remarkable grasping skills of the human hand rely more on the independent abduction/adduction of the fingers than on their independent flexion/extension. These findings are of interest to the designers of artificial hands, including biomimetic prostheses and exoskeletons.

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Save that arm

Cited by 103 publications

References 6 publications

Deprivation-related and use-dependent plasticity go hand in hand

Deprivation-related and use-dependent plasticity go hand in hand

Case-study of a user-driven prosthetic arm design: bionic hand versus customized body-powered technology in a highly demanding work environment

Independent Long Fingers are not Essential for a Grasping Hand

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