Control within a virtual environment is correlated to functional outcomes when using a physical prosthesis

Levi Hargrove*, Laura Miller, Kristi Turner, Todd Kuiken

*Corresponding author for this work

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Advances such as targeted muscle reinnervation and pattern recognition control may provide improved control of upper limb myoelectric prostheses, but evaluating user function remains challenging. Virtual environments are cost-effective and immersive tools that are increasingly used to provide practice and evaluate prosthesis control, but the relationship between virtual and physical outcomes - i.e., whether practice in a virtual environment translates to improved physical performance - is not understood. Methods: Nine people with transhumeral amputations who previously had targeted muscle reinnervation surgery were fitted with a myoelectric prosthesis comprising a commercially available elbow, wrist, terminal device, and pattern recognition control system. Virtual and physical outcome measures were obtained before and after a 6-week home trial of the prosthesis. Results: After the home trial, subjects showed statistically significant improvements (p < 0.05) in offline classification error, the virtual Target Achievement Control test, and the physical Southampton Hand Assessment Procedure and Box and Blocks Test. A trend toward improvement was also observed in the physical Clothespin Relocation task and Jebsen-Taylor test; however, these changes were not statistically significant. The median completion time in the virtual test correlated strongly and significantly with the Southampton Hand Assessment Procedure (p = 0.05, R = - 0.86), Box and Blocks Test (p = 0.007, R = - 0.82), Jebsen-Taylor Test (p = 0.003, R = 0.87), and the Assessment of Capacity for Myoelectric Control (p = 0.005,R = - 0.85). The classification error performance only had a significant correlation with the Clothespin Relocation Test (p = 0.018, R =.76). Conclusions: In-home practice with a pattern recognition-controlled prosthesis improves functional control, as measured by both virtual and physical outcome measures. However, virtual measures need to be validated and standardized to ensure reliability in a clinical or research setting. Trial registration: This is a registered clinical trial: NCT03097978.

Original languageEnglish (US)
Article number60
JournalJournal of neuroengineering and rehabilitation
Volume15
DOIs
StatePublished - Sep 5 2018

Fingerprint

Prostheses and Implants
Automated Pattern Recognition
Hand
Artificial Limbs
Outcome Assessment (Health Care)
Muscles
Elbow
Wrist
Amputation
Upper Extremity
Clinical Trials
Costs and Cost Analysis
Equipment and Supplies
Research

Keywords

  • Myoelectric control
  • Outcomes
  • Pattern recognition
  • Prosthetics

ASJC Scopus subject areas

  • Rehabilitation
  • Health Informatics

Cite this

@article{185dcd73cf4f4cb3bdb9b6a2ab2423f2,
title = "Control within a virtual environment is correlated to functional outcomes when using a physical prosthesis",
abstract = "Background: Advances such as targeted muscle reinnervation and pattern recognition control may provide improved control of upper limb myoelectric prostheses, but evaluating user function remains challenging. Virtual environments are cost-effective and immersive tools that are increasingly used to provide practice and evaluate prosthesis control, but the relationship between virtual and physical outcomes - i.e., whether practice in a virtual environment translates to improved physical performance - is not understood. Methods: Nine people with transhumeral amputations who previously had targeted muscle reinnervation surgery were fitted with a myoelectric prosthesis comprising a commercially available elbow, wrist, terminal device, and pattern recognition control system. Virtual and physical outcome measures were obtained before and after a 6-week home trial of the prosthesis. Results: After the home trial, subjects showed statistically significant improvements (p < 0.05) in offline classification error, the virtual Target Achievement Control test, and the physical Southampton Hand Assessment Procedure and Box and Blocks Test. A trend toward improvement was also observed in the physical Clothespin Relocation task and Jebsen-Taylor test; however, these changes were not statistically significant. The median completion time in the virtual test correlated strongly and significantly with the Southampton Hand Assessment Procedure (p = 0.05, R = - 0.86), Box and Blocks Test (p = 0.007, R = - 0.82), Jebsen-Taylor Test (p = 0.003, R = 0.87), and the Assessment of Capacity for Myoelectric Control (p = 0.005,R = - 0.85). The classification error performance only had a significant correlation with the Clothespin Relocation Test (p = 0.018, R =.76). Conclusions: In-home practice with a pattern recognition-controlled prosthesis improves functional control, as measured by both virtual and physical outcome measures. However, virtual measures need to be validated and standardized to ensure reliability in a clinical or research setting. Trial registration: This is a registered clinical trial: NCT03097978.",
keywords = "Myoelectric control, Outcomes, Pattern recognition, Prosthetics",
author = "Levi Hargrove and Laura Miller and Kristi Turner and Todd Kuiken",
year = "2018",
month = "9",
day = "5",
doi = "10.1186/s12984-018-0402-y",
language = "English (US)",
volume = "15",
journal = "Journal of NeuroEngineering and Rehabilitation",
issn = "1743-0003",
publisher = "BioMed Central",

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TY - JOUR

T1 - Control within a virtual environment is correlated to functional outcomes when using a physical prosthesis

AU - Hargrove, Levi

AU - Miller, Laura

AU - Turner, Kristi

AU - Kuiken, Todd

PY - 2018/9/5

Y1 - 2018/9/5

N2 - Background: Advances such as targeted muscle reinnervation and pattern recognition control may provide improved control of upper limb myoelectric prostheses, but evaluating user function remains challenging. Virtual environments are cost-effective and immersive tools that are increasingly used to provide practice and evaluate prosthesis control, but the relationship between virtual and physical outcomes - i.e., whether practice in a virtual environment translates to improved physical performance - is not understood. Methods: Nine people with transhumeral amputations who previously had targeted muscle reinnervation surgery were fitted with a myoelectric prosthesis comprising a commercially available elbow, wrist, terminal device, and pattern recognition control system. Virtual and physical outcome measures were obtained before and after a 6-week home trial of the prosthesis. Results: After the home trial, subjects showed statistically significant improvements (p < 0.05) in offline classification error, the virtual Target Achievement Control test, and the physical Southampton Hand Assessment Procedure and Box and Blocks Test. A trend toward improvement was also observed in the physical Clothespin Relocation task and Jebsen-Taylor test; however, these changes were not statistically significant. The median completion time in the virtual test correlated strongly and significantly with the Southampton Hand Assessment Procedure (p = 0.05, R = - 0.86), Box and Blocks Test (p = 0.007, R = - 0.82), Jebsen-Taylor Test (p = 0.003, R = 0.87), and the Assessment of Capacity for Myoelectric Control (p = 0.005,R = - 0.85). The classification error performance only had a significant correlation with the Clothespin Relocation Test (p = 0.018, R =.76). Conclusions: In-home practice with a pattern recognition-controlled prosthesis improves functional control, as measured by both virtual and physical outcome measures. However, virtual measures need to be validated and standardized to ensure reliability in a clinical or research setting. Trial registration: This is a registered clinical trial: NCT03097978.

AB - Background: Advances such as targeted muscle reinnervation and pattern recognition control may provide improved control of upper limb myoelectric prostheses, but evaluating user function remains challenging. Virtual environments are cost-effective and immersive tools that are increasingly used to provide practice and evaluate prosthesis control, but the relationship between virtual and physical outcomes - i.e., whether practice in a virtual environment translates to improved physical performance - is not understood. Methods: Nine people with transhumeral amputations who previously had targeted muscle reinnervation surgery were fitted with a myoelectric prosthesis comprising a commercially available elbow, wrist, terminal device, and pattern recognition control system. Virtual and physical outcome measures were obtained before and after a 6-week home trial of the prosthesis. Results: After the home trial, subjects showed statistically significant improvements (p < 0.05) in offline classification error, the virtual Target Achievement Control test, and the physical Southampton Hand Assessment Procedure and Box and Blocks Test. A trend toward improvement was also observed in the physical Clothespin Relocation task and Jebsen-Taylor test; however, these changes were not statistically significant. The median completion time in the virtual test correlated strongly and significantly with the Southampton Hand Assessment Procedure (p = 0.05, R = - 0.86), Box and Blocks Test (p = 0.007, R = - 0.82), Jebsen-Taylor Test (p = 0.003, R = 0.87), and the Assessment of Capacity for Myoelectric Control (p = 0.005,R = - 0.85). The classification error performance only had a significant correlation with the Clothespin Relocation Test (p = 0.018, R =.76). Conclusions: In-home practice with a pattern recognition-controlled prosthesis improves functional control, as measured by both virtual and physical outcome measures. However, virtual measures need to be validated and standardized to ensure reliability in a clinical or research setting. Trial registration: This is a registered clinical trial: NCT03097978.

KW - Myoelectric control

KW - Outcomes

KW - Pattern recognition

KW - Prosthetics

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