title: An investigation into the perceptual embodiment of an artificial hand using transcutaneous electrical nerve stimulation (TENS) in intact-limbed individuals.
abstract: BACKGROUND
  Perceptual embodiment of an artificial limb aids manual control of prostheses and can be facilitated by somatosensory feedback. We hypothesised that transcutaneous electrical nerve stimulation (TENS) may facilitate perceptual embodiment of artificial limbs.
  
  
  OBJECTIVE
  To determine the effect of TENS on perceptual embodiment of an artificial hand in 32 intact-limbed participants.
  
  
  METHODS
  Participants were exposed to four experimental conditions in four counterbalanced blocks: (i) Vision (V) watching an artificial hand positioned congruently to the real hand (out of view); (ii) Vision and strong non-painful TENS in the real hand (V+T); Vision and Stroking (V+S) of the artificial and real hand with a brush; Vision, Stroking and TENS (V+S+T) watching artificial hand being stroked whilst real hand was stroked and receiving TENS.
  
  
  RESULTS
  Repeated measure ANOVA detected effects for Condition (P< 0.001), Block (P< 0.001) and Condition x Block interaction (P< 0.001). Pairwise comparisons detected more intense perceptual embodiment for V+S+T compared with V (P< 0.001) and V+T (P< 0.001), and for V+S compared with V (P< 0.001) and V+T (P< 0.001).The intensity of perceptual embodiment increased for later blocks (P< 0.001).
  
  
  CONCLUSIONS
  A sensation of TENS was generated within the artificial hand in individuals with intact limbs and this facilitated perceptual embodiment. The magnitude of effect was modest.
authors.affiliation: Faculty of Health and Social Sciences, Leeds Metropolitan University, Leeds, UK Leeds Pallium Research Group, Leeds, UK.
authors.forename: Matthew
authors.initials: M
authors.lastname: Mulvey
authors.affiliation: Faculty of Health and Social Sciences, Leeds Metropolitan University, Leeds, UK Leeds Pallium Research Group, Leeds, UK.
authors.forename: Helen
authors.initials: H
authors.lastname: Fawkner
authors.affiliation: Faculty of Health and Social Sciences, Leeds Metropolitan University, Leeds, UK Leeds Pallium Research Group, Leeds, UK.
authors.forename: Mark I
authors.initials: MI
authors.lastname: Johnson
mesh_terms: D000328:Adult; D000674:Amputees; D000704:Analysis of Variance; D001186:Artificial Limbs; D005260:Female; D006225:Hand; D006801:Humans; D008297:Male; D011434:Proprioception / Q000502:physiology*; D011930:Reaction Time; D012016:Reference Values; D012494:Sampling Studies; D004561:Transcutaneous Electric Nerve Stimulation / Q000379:methods*; D055815:Young Adult
keywords: Transcutaneous electrical nerve stimulation (TENS); amputation; artificial limb; body image; perceptual embodiment; rehabilitation