title: A Structured Rehabilitation Protocol for Improved Multifunctional Prosthetic Control: A Case Study.
abstract: Advances in robotic systems have resulted in prostheses for the upper limb that can produce multifunctional movements. However, these sophisticated systems require upper limb amputees to learn complex control schemes. Humans have the ability to learn new movements through imitation and other learning strategies. This protocol describes a structured rehabilitation method, which includes imitation, repetition, and reinforcement learning, and aims to assess if this method can improve multifunctional prosthetic control. A left below elbow amputee, with 4 years of experience in prosthetic use, took part in this case study. The prosthesis used was a Michelangelo hand with wrist rotation, and the added features of wrist flexion and extension, which allowed more combinations of hand movements. The participant's Southampton Hand Assessment Procedure score improved from 58 to 71 following structured training. This suggests that a structured training protocol of imitation, repetition and reinforcement may have a role in learning to control a new prosthetic hand. A larger clinical study is however required to support these findings.
authors.affiliation: Christian Doppler Laboratory for Restoration of Extremity Function; Department of Surgery, Division of Plastic and Reconstructive Surgery, Medical University of Vienna; aidan.roche@meduniwien.ac.at.
authors.forename: Aidan Dominic
authors.initials: AD
authors.lastname: Roche
authors.affiliation: Department of Neurorehabilitation Engineering, Bernstein Focus Neurotechnology Göttingen; University Medical Center Göttingen, Georg-August University.
authors.forename: Ivan
authors.initials: I
authors.lastname: Vujaklija
authors.affiliation: Department of Neurorehabilitation Engineering, Bernstein Focus Neurotechnology Göttingen; University Medical Center Göttingen, Georg-August University.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Amsüss
authors.affiliation: Christian Doppler Laboratory for Restoration of Extremity Function; University of Applied Sciences FH Campus Wien.
authors.forename: Agnes
authors.initials: A
authors.lastname: Sturma
authors.affiliation: Research & Development, Otto Bock Healthcare Products GmbH.
authors.forename: Peter
authors.initials: P
authors.lastname: Göbel
authors.affiliation: Department of Neurorehabilitation Engineering, Bernstein Focus Neurotechnology Göttingen; University Medical Center Göttingen, Georg-August University.
authors.forename: Dario
authors.initials: D
authors.lastname: Farina
authors.affiliation: Christian Doppler Laboratory for Restoration of Extremity Function; Department of Surgery, Division of Plastic and Reconstructive Surgery, Medical University of Vienna.
authors.forename: Oskar C
authors.initials: OC
authors.lastname: Aszmann
mesh_terms: D000328:Adult; D000674:Amputees / Q000534:rehabilitation*; D001186:Artificial Limbs; D004550:Elbow / Q000502:physiology; D006225:Hand / Q000502:physiology; D006801:Humans; D008297:Male; D009068:Movement / Q000502:physiology; D019919:Prosthesis Implantation; D016059:Range of Motion, Articular