Division of Biomedical Physics, Food and Drug Administration, Silver Spring, Maryland, United States of America.
Department of Bioengineering, University of Maryland, College Park, Maryland, United States of America.
PLoS One. 2020 Jan 24;15(1):e0226563. doi: 10.1371/journal.pone.0226563. eCollection 2020.
Motor learning and compensatory movement are important aspects of prosthesis training yet relatively little quantitative evidence supports our current understanding of how motor control and compensation develop in the novel body-powered prosthesis user. The goal of this study is to assess these aspects of prosthesis training through functional, kinematic, and kinetic analyses using a within-subject paradigm compared across two training time points. The joints evaluated include the left and right shoulders, torso, and right elbow. Six abled-bodied subjects (age 27 ± 3) using a body-powered bypass prosthesis completed the Jebsen-Taylor Hand Function Test and the targeted Box and Blocks Test after five training sessions and again after ten sessions. Significant differences in movement parameters included reduced times to complete tasks, reduced normalized jerk for most joints and tasks, and more variable changes in efficiency and compensation parameters for individual tasks and joints measured as range of motion, maximum angle, and average moment. Normalized jerk, joint specific path length, range of motion, maximum angle, and average moment are presented for the first time in this unique training context and for this specific device type. These findings quantitatively describe numerous aspects of motor learning and control in able-bodied subjects that may be useful in guiding future rehabilitation and training of body-powered prosthesis users.
运动学习和代偿运动是假肢训练的重要方面,但目前我们对于新手使用新型身体动力假肢时运动控制和代偿的发展过程,仅有相对较少的定量证据支持。本研究的目的是通过使用基于个体的范式,在两个训练时间点进行比较,从功能、运动学和动力学分析方面来评估假肢训练的这些方面。评估的关节包括左侧和右侧肩部、躯干和右侧肘部。6 名使用身体动力旁路假肢的健全受试者(年龄 27 ± 3)在完成五次训练后和十次训练后,完成了杰普森-泰勒手功能测试和目标箱和方块测试。运动参数的显著差异包括完成任务的时间减少,大多数关节和任务的归一化急动度减少,以及个体任务和关节的效率和补偿参数的变化更加多变,这些参数以运动范围、最大角度和平均力矩来衡量。归一化急动度、特定关节的路径长度、运动范围、最大角度和平均力矩是在这种独特的训练环境中和针对这种特定设备类型首次呈现的。这些发现定量描述了健全受试者中运动学习和控制的许多方面,这可能有助于指导未来身体动力假肢使用者的康复和训练。