Abstract
BackgroundLittle is known about action-perception learning processes underlying prosthetic skills in body-powered prosthesis users. Body-powered prostheses are controlled through a harness connected by a cable that might provide for limited proprioceptive feedback. This study aims to test transfer of training basic tasks to functional tasks and to describe the changes over time in kinematics of basic tasks of novice body-powered prosthesis users.MethodsThirty able-bodied participants and 17 controls participated in the study, using a body-powered prosthetic simulator. Participants in the training group were divided over four groups and practiced during a 2-week-period either direct grasping, indirect grasping, fixation, or a combination of these tasks. Deformable objects with different compliances had to be manipulated while kinematic variables and grip force control were assessed. Functional performance was measured with the Southampton Hand Assessment Procedure (SHAP) prior to and after the training sessions, and after 2 weeks and 3 months retention. The control group only performed the SHAP tests.ResultsAll four training groups and the control group improved on the SHAP, also after a period of non-use. Type of training had a small but significant influence on the improvements of the SHAP score. On a kinematic level movement times decreased and hook closing velocities increased over time. The indirect grasping group showed significantly shorter plateau times than the other training groups. Grip force control only improved a little over training.ConclusionsTraining action-perception couplings of body-powered prosthesis in basic tasks transferred to functional tasks and this lasted after a period of non-use. During training movement times decreased and the indirect grasping group showed advantages. It is advisable to start body-powered training with indirect grasping tasks but also to practice hook-object orientations.Electronic supplementary materialThe online version of this article (doi:10.1186/s12984-016-0197-7) contains supplementary material, which is available to authorized users.
Highlights
Little is known about action-perception learning processes underlying prosthetic skills in body-powered prosthesis users
A repeated measures Analysis of variance (ANOVA) on the Index of Functionality (IoF)-scores demonstrated a main effect of test, in that the four training groups and control group improved on IoF-scores on the posttest, Retention test after weeks (RT1) and Retention test after months (RT2) compared with the pretest and improved from posttest to RT1 and RT2 (p’s < .001 in pairwise comparison) (Table 1)
The fixation tasks (FIX) group showed a steady improvement compared to the control group over the posttest and the retention tests
Summary
Little is known about action-perception learning processes underlying prosthetic skills in body-powered prosthesis users. Functional use of a prosthesis is usually measured with a testing instrument that analyzes task completion times of activities of daily living (ADL). The usage of such an instrument prior to and after a training could show whether training affected the transfer of the learned skill to the performance of functional tasks with the prosthesis. The performance of body-powered prosthesis users improves on the Box and Block Test and the Nine Hole Peg Test after a short training period [10] Another instrument that is frequently reported and used by clinicians is the Southampton Hand Assessment Procedure (SHAP) [11]. SHAP measures at both the function and activity level of the ICF (International Classification of Functioning, disability and health), and especially on the level of functional performance in ADL tasks we wanted to establish effects of training (cf. [13])
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
