Abstract
The aim of this study was to determine whether virtual training improves grip force control in prosthesis use, and to examine which type of augmented feedback facilitates its learning most. Thirty-two able-bodied participants trained grip force with a virtual ball-throwing game for five sessions in a two-week period, using a myoelectric simulator. They received either feedback on movement outcome or on movement execution. Sixteen controls received training that did not focus on force control. Variability over learning was examined with the Tolerance-Noise-Covariation approach, and the transfer of grip force control was assessed in five test-tasks that assessed different aspects of force control in a pretest, a posttest and a retention test. During training performance increased while the variability in performance was decreased, mainly by reduction in noise. Grip force control only improved in the test-tasks that provided information on performance. Starting the training with a task that required low force production showed no transfer of the learned grip force. Feedback on movement execution was detrimental to grip force control, whereas feedback on movement outcome enhanced transfer of grip force control to tasks other than trained. Clinical implications of these results regarding virtual training of grip force control are discussed.
Highlights
To use an upper limb prosthesis dexterously, one needs training [1,2,3].An evidence-based training should optimally facilitate skill acquisition, thereby enhancing functionality and efficiency with a prosthesis during training, and promoting transfer of skills from training to everyday life situations
Learning to usea prosthesis implies that motor learning takes place, which is generally seen as the permanent changes in behavior as result of practice [4]
We examined the influence of feedback on the learning process while training with a myoelectric prosthesis
Summary
To use an upper limb prosthesis dexterously, one needs training [1,2,3].An evidence-based training should optimally facilitate skill acquisition, thereby enhancing functionality and efficiency with a prosthesis during training, and promoting transfer of skills from training to everyday life situations. Practice is one of the most important factors in motor learning as the degree of improvement depends on the amount of practice [4,5]. Another factor that has effect on the motor learning process is feedback [5]. We examined the influence of feedback on the learning process while training with a myoelectric prosthesis. Revealing those motor learning processes of prosthesis users allows designing evidence-based training protocols that optimize these learning processes. Therapists could benefit from such protocols to enhance prosthesis skills
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