Kinematic Improvement Differs Between Transradial Versus Partial-Hand Prosthesis Use Following Interlimb Training
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About 33% of upper extremity amputees reject their prosthetic device due to perceived lack of functionality in daily life (Cusack et al., 2014). A way to bypass the lack of device use during the healing period is to begin training with a prosthesis simulator on the sound limb. This technique is known as interlimb transfer (ILT) and has the goal of allowing for the transfer of learned skills from the trained (non-amputated) limb to the affected limb. To investigate ILT, participants used one of two prosthesis simulators. The transradial prosthesis simulator (TrPS) simulated an amputation between the elbow and wrist, and the partial-hand prosthesis simulator (PhPS) simulated the loss of digits 1-3 at the metacarpophalangeal joint. In addition to being grouped by device (PhPS or TrPS), participants were also grouped into either the training or control group. Both groups underwent an identical pre-test and post-test on day 1 and day 5 of the study consisting of four motor tasks. The training group completed three days of the training paradigm on days 2-4 of the study. It was hypothesized that participants using a partial-hand prosthesis will have shorter movement duration, higher accuracy, higher peak velocity, and lower movement variability compared to participants using a transradial prosthesis. Additionally, it was hypothesized that participants partaking in interlimb training will show decreases in movement duration, increases in accuracy, increases in peak velocity, and decreases in movement variability compared to controls. By examining percent change from the first day of training (day 2) to the final day of training (day 4), it was found that more trials were completed, the time required to complete each trial decreased, and the number of errors committed decreased as the training paradigm progressed which indicates that an improvement was seen in all aspects of training. The PhPS group showed greater changes in performance for all 3 measures compared to the TrPS group which supports the initial hypothesis. In regards to accuracy, for the TrPS group in the metal disk translation task, an ANOVA conducted on average number of errors for both groups (training and control) over the course of the experimental paradigm (day 1 and day 5) resulted in a near significant p-value of 0.0887 between groups (training vs. control). This suggests a trend towards support of the hypothesis with participants partaking in interlimb training showing increases in accuracy compared to controls. According to the preliminary analysis that has been conducted, interlimb transfer appears to improve functional performance when using a prosthesis simulator, and the PhPS group seems to improve the most.