Learning to use a body-powered prosthesis: changes in functionality and kinematics.
Learning to use a body-powered prosthesis: changes in functionality and kinematics.
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DOI：
10.1186/s12984-016-0197-7
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发表时间：
2016-10-07
影响因子：
5.1
通讯作者：
Bongers RM
中科院分区：
文献类型：
--
作者：
Huinink LH;Bouwsema H;Plettenburg DH;van der Sluis CK;Bongers RM
很少有人知道身体动力假肢用户的假肢技能的动作感知学习过程。身体驱动的假肢是通过一个由电缆连接的线束控制的，电缆可能提供有限的本体感受反馈。本研究的目的是测试培训的基本任务的功能性任务的转移，并描述随着时间的推移，在运动学的基本任务的新手身体动力假肢用户的变化。30名身体健全的参与者和17名对照者参加了这项研究，使用身体动力假肢模拟器。训练组的参与者被分成四组，在两周的时间里进行直接抓握、间接抓握、固定或这些任务的组合。具有不同顺应性的可变形物体被操纵，而运动学变量和握力控制进行了评估。在训练之前和之后，以及在2周和3个月的保留之后，使用南安普顿手评估程序（SHAP）测量功能性能。对照组仅进行SHAP试验。所有四个训练组和对照组在SHAP上都有所改善，也是在一段时间不使用之后。训练类型对SHAP评分的改善有较小但显著的影响。在运动学水平上，运动时间随着时间的推移而减少，钩闭合速度随着时间的推移而增加。间接抓握组的平台时间明显短于其他训练组。握力控制在训练中只提高了一点。人体动力假肢在基本任务中的训练动作-知觉耦合转移到功能任务中，并且在一段时间不使用后持续。在训练过程中，运动次数减少，间接抓握组表现出优势。建议从间接抓握任务开始身体动力训练，但也要练习钩物体定向。本文的在线版本（doi：10.1186/s12984-016-0197-7）包含补充材料，可供授权用户使用。
Little 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. Thirty 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. All 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. Training 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. The online version of this article (doi:10.1186/s12984-016-0197-7) contains supplementary material, which is available to authorized users.
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