Training protocol for a powered shoulder prosthesis

Resnik, Linda; Klinger, Shana Lieberman; Korp, Kathryn; Walters, Lisa Smurr

doi:10.1682/jrrd.2014.07.0162

Cited by 12 publications

(9 citation statements)

References 12 publications

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“…This portion of the training served several purposes. It encouraged subjects to experiment with motions and activities individually, facilitating greater personal confidence with the device and maintenance of some natural variability between users [21]. We also wanted to maintain subject engagement throughout the session by providing time with more freedom to pursue tasks of interest within the limitations of the controlled setting.…”

Section: Methodsmentioning

confidence: 99%

“…Finally, ten ADL tasks were performed during a 20-minute period. ADL tasks have long been used in rehabilitation to train amputees and have been included in multiple training studies [2,10,21]. From multiple collections of listed ADLs, eight were selected specifically from the Activities Measure for Upper Limb Amputees, for their explicit instructions and reproducibility as well as their strength as part of a validated outcome measure [22].…”

Section: Methodsmentioning

confidence: 99%

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

Bloomer

Wang

Kontson

2018

Phys Med Rehabil Res

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We aim to present a standard protocol for training able-bodied individuals to use a body-powered bypass prosthesis and assess training length and impact of prepositioning. The protocol design and subsequent analysis aims to facilitate controlled and efficient implementation of the able-bodied bypass user in the research setting. Six volunteers completed ten two-hour sessions with a body-powered bypass prosthesis. Each session included standardized training tasks: object manipulation, free training, and activities of daily living. Two outcome measures, a modified Southampton Hand Assessment Procedure and the Box and Blocks Test were used to score performance during each session. A standard learning curve was fitted to the scores to determine an optimal training length based on learning rate and learning plateau values; further tested through an effect size calculation. To assess prepositioning, scores were normalized and grouped by a measure of terminal device rotations. Scores then underwent a linear regression analysis. Optimal training lengths were found to be three and six sessions for modified Southampton Hand Assessment Procedure and Box and Blocks Test results respectively, with support from effect size calculations. Prepositioning and normalized score were weakly correlated, +0.38, and poorly fit, R 2 = 0.016, contradictory to the expected strong correlation that would accompany the supposed performance benefits attributed to prepositioning. A lack of resources to guide the use of upper limb bypass prostheses is addressed with the presented standard, quantitatively assessed protocol. A framework for evaluating adequate training length and prepositioning is established and shared.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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

Bloomer

Wang

Kontson

2018

Phys Med Rehabil Res

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“…During training, subjects learned to don and doff the DEKA Arm, and to understand and operate its features. During Virtual Reality Environment (VRE) training, IMU users were oriented to DEKA Arm operations using a standardized protocol [ 9 , 10 ]. EMG-PR users utilized the virtual reality system provided by the COAPT Complete Control software (COAPT Complete Control, Chicago, IL).…”

Section: Methodsmentioning

confidence: 99%

EMG pattern recognition compared to foot control of the DEKA Arm

et al. 2018

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IntroductionEMG pattern recognition control (EMG-PR) is a promising option for control of upper limb prostheses with multiple degrees of freedom (DOF). The purposes of this study were to 1) evaluate outcomes of EMG-PR and inertial measurement units (IMU) control of the DEKA Arm as compared to personal prosthesis; and 2) compare outcomes of EMG-PR to IMU control of DEKA Arm.MethodsThis was a quasi-experimental, multi-site study with repeated measures that compared non-randomized groups using two types of controls: EMG-PR and IMUs. Subjects (N = 36) were transradial (TR) and transhumeral (TH) amputees. Outcomes were collected at Baseline (using personal prosthesis), and after in-laboratory training (Part A), and home use (Part B). Data was compared to personal prosthesis, stratified by amputation level and control type. Outcomes were also compared by control type.ResultsThe EMG-PR group had greater prosthesis use after Part A, but worse dexterity, lower satisfaction, and slower activity performance compared to Baseline; the IMU group had slower activity performance. After Part B, the EMG-PR group had less perceived activity difficulty; the IMU group had improved activity performance, improved disability and activity difficulty, but slower performance. No differences were observed for TH group by control type in Part A or B. The TR group using EMG-PR had worse dexterity (Parts A & B), and activity performance (Part A) as compared to IMU users.Discussion/ConclusionFindings suggest that for the TR group that IMUs are a more effective control method for the DEKA Arm as compared to the EMG-PR prototypes employed in this study. Further research is needed to refine the EMG-PR systems for multi-DOF devices. Future studies should include a larger sample of TH amputees.Trial registrationClinicalTrials.gov NCT01551420.

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“…Participants were then oriented to the DEKA Arm features and controls by the study Occupational therapist and used the DEKA Arm’s virtual reality training environment (VRE) with a standardized VRE protocol developed for the study. [11] Participants practiced controlling the prosthesis within the VRE for up to 4 hours, prior to wearing the activated DEKA Arm. [12] After VRE, training began with the activated DEKA Arm.…”

Section: Methodsmentioning

confidence: 99%

Use of the DEKA Arm for amputees with brachial plexus injury: A case series

et al. 2017

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ObjectivePatients with upper limb amputation and brachial plexus injuries have high rates of prosthesis rejection. Study purpose is to describe experiences of subjects with transhumeral amputation and brachial plexus injury, who were fit with, and trained to use, a DEKA Arm.MethodsThis was a mixed-methods study utilizing qualitative (e.g. interview, survey) and quantitative data (e.g. self-report and performance measures). Subject 1, a current prosthesis user, had a shoulder arthrodesis. Subject 2, not a prosthesis user, had a subluxed shoulder. Both were trained in laboratory and participated in a trial of home use. Descriptive analyses of processes and outcomes were conducted.ResultsSubject 1 was fitted with the transhumeral configuration (HC) DEKA Arm using a compression release stabilized socket. He had 12 hours of prosthetic training and participated in all home study activities. Subject 1 had improved dexterity and prosthetic satisfaction with the DEKA Arm and reported better quality of life (QOL) at the end of participation. Subject 2 was fit with the shoulder configuration (SC) DEKA Arm using a modified X-frame socket. He had 30 hours of training and participated in 3 weeks of home activities. He reported less functional disability at the end of training as compared to baseline, but encountered personal problems and exacerbation of PTSD symptoms and withdrew from home use portion at 3 weeks. Both subjects reported functional benefits from use, and expressed a desire to receive a DEKA Arm in the future.DiscussionThis paper reported on two different strategies for prosthetic fitting and their outcomes. The advantages and limitations of each approach were discussed.ConclusionUse of both the HC and SC DEKA Arm for patients with TH amputation and brachial plexus injury was reported. Lessons learned may be instructive to clinicians considering prosthetic choices for future cases.

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Training protocol for a powered shoulder prosthesis

Cited by 12 publications

References 12 publications

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

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

EMG pattern recognition compared to foot control of the DEKA Arm

Use of the DEKA Arm for amputees with brachial plexus injury: A case series

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