The benefits of sensation on the experience of a hand: A qualitative case series

Abstract

BackgroundThe experience of upper limb loss involves loss of both functional capabilities and the sensory connection of a hand. Research studies to restore sensation to persons with upper limb loss with neural interfaces typically measure outcomes through standardized functional tests or quantitative surveys. However, these types of metrics cannot fully capture the personal experience of living with limb loss or the impact of sensory restoration on this experience. Qualitative studies can demonstrate the viewpoints and priorities of specific persons or groups and reveal the underlying conceptual structure of various aspects of their experiences.Methods and findingsFollowing a home use trial of a neural-connected, sensory-enabled prosthesis, two persons with upper limb loss were interviewed about their experiences using the sensory restoration system in unsupervised, unconstrained settings. We used grounded theory methodology to examine their experiences, perspectives, and opinions about the sensory restoration system. We then developed a model to describe the impact of sensation on the experience of a hand for persons with upper limb loss.ConclusionsThe experience of sensation was complex and included concepts such as the naturalness of the experience, sensation modality, and the usefulness of the sensory information. Sensation was critical for outcome acceptance, and contributed to prosthesis embodiment, confidence, reduced focus and attention for using the prosthesis, and social interactions. Embodiment, confidence, and social interactions were also key determinants of outcome acceptance. This model provides a unified framework to study and understand the impact of sensation on the experience of limb loss and to understand outcome acceptance following upper limb loss more broadly.

Neural feedback strategies to improve grasping coordination in neuromusculoskeletal prostheses

“…Whereas certain modes of pulse modulation have been described to transform paresthesia to more natural qualia 6 , these www.nature.com/scientificreports/ findings have not been replicated yet 48 . However, in addition to the aforementioned paresthetic sensations, our subjects also reported more natural sensations such as "pressure" and "touch", which agrees with reports by other groups 42,44,45,49,50 . The presence of sensations recognizable as natural might be the cause for subjects reporting a "possibly" or "almost" natural experience 51 .…”

Neuromusculoskeletal Arm Prostheses: Personal and Social Implications of Living With an Intimately Integrated Bionic Arm

“…As such, the implanted electrodes seem to have raised both patients' confidence in and expectations for the degree of control they can expect of their prostheses. Previous studies have suggested that distrust or degrees of caution and risk aversion toward limb prostheses could be due to early adoption or ongoing device development (Graczyk et al, 2019). This was not observed in our participants owing potentially to the reliability and long-term stability of the neuromusculoskeletal prosthetic system when used unsupervised in daily life.…”

“…The ambiguity surrounding the use of the word "natural" underscores the importance of identifying what such generalized descriptors mean to participants in different contexts. Previous qualitative studies invoking the term "natural" with regard to describing sensory feedback have not differentiated between these multiple contexts and possible nuances in meaning (Graczyk et al, 2019). This suggests the need for ongoing research on the various possible meanings of the term "natural" and the importance of precision when using it in qualitative and quantitative research on artificially elicited sensation.…”

“…Whereas qualitative research has been limited and conducted in the context of less intimately integrated limb prostheses (Murray, 2004;Lundberg et al, 2011;Widehammar et al, 2018;Cuberovic et al, 2019;Franzke et al, 2019;Graczyk et al, 2019;Hansen et al, 2019), it has nevertheless shown that the perspectives and opinions of those impacted by such medical interventions form a particular kind of evidence and expertise (Murray, 2004). The embodied knowledge (Merleau-Ponty, 1962;Bourdieu, 1990) produced from firsthand experience is unique from data gathered from traditional quantitative methods, serving to complement and at times even challenge quantitative data.…”

A Prototype for Temperature Sensation System for Arm Amputee Handicap

“…And the number much more in other countries .However, about 21% of handicaps with upper limb loss disability don't use any artificial arm because they think it does not provide their needs. About 85% of them consider the lack of sensation as a factor to their think [2]. As a result of these, researchers interesting increases to reach better results to enhance the functionality of the artificial limbs.…”