Abstract
The effect that a motor skill trained on one side can lead to improvement in the untrained side is called intermanual transfer. Intermanual transfer can help enhance upper limb prosthetic training. To determine the influence of mirror therapy and motor imagery on intermanual transfer in upper limb prosthesis training, a pseudo-randomized clinical trial, single blinded, with a pre-posttest design was used. Forty-seven able-bodied, right-handed participants were pseudo-randomly assigned to two training groups and one control group. One training group undertook an intermanual transfer training program, using an upper-limb prosthetic simulator with added mirror therapy and motor imagery. The second training group completed only the intermanual transfer training program. The control group completed a sham training: a dummy training without using the prosthesis simulator. The program lasted five consecutive days. To determine the improvement in skill, a test was administered before, immediately after, and six days after the training program. Training used the “unaffected” arm; tests were performed with the “affected” arm, resembling the amputated limb. Movement time, the time from the beginning of the movement until completion of the task; hand opening, the duration of the maximum prosthetic hand opening; and grip-force control, the deviation from the required force during a tracking task. No intermanual transfer effects were found: neither the intermanual transfer training program, nor the additional mirror therapy and motor imagery affected prosthesis skills. A limitation of the study was that the training program was applied to able-bodied subjects instead of patients with an amputation. Contrary to previous studies, no intermanual transfer effects were found. Additional mirror therapy and motor imagery did not ameliorate intermanual transfer effects.
Highlights
Intermanual transfer effects can be used to improve prosthesis training in able-bodied[1,2,3,4] and amputees [5]
Mirror therapy, and motor imagery training group was compared with a group training only intermanual transfer, and with a control group
No significant differences were found between the three training groups
Summary
Intermanual transfer effects can be used to improve prosthesis training in able-bodied[1,2,3,4] and amputees [5]. Intermanual transfer involves motor skills trained on one side of the body transferring to the other side.[6,7,8,9] For prosthetic training this means that, when the unaffected hand is trained, motor skills of the affected limb improve. The rationale for using intermanual transfer in prosthetic training is that training can start early in rehabilitation and, as a result, might improve handling and acceptance of the prosthesis.[10,11,12] Even though the transfer effect has previously been shown in prosthetic training in able-bodied[1,2,3,4] as well as in persons with an amputation[5], the effect was found to be rather small.
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