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
N1 - Funding Information:
This work was supported by DoD Award OR110187 (W81XWH-12-2-0072). The funding body played no role in study design; collection, analysis, or interpretation of data; or writing the manuscript. The publication cost of this article was funded by discretionary funds provided to the authors by the Shirley Ryan AbilityLab.
Publisher Copyright:
© 2018 The Author(s).
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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U2 - 10.1186/s12984-018-0402-y
DO - 10.1186/s12984-018-0402-y
M3 - Article
C2 - 30255800
AN - SCOPUS:85053139266
VL - 15
JO - Journal of NeuroEngineering and Rehabilitation
JF - Journal of NeuroEngineering and Rehabilitation
SN - 1743-0003
M1 - 60
ER -