Rehabilitation Clinic Tobelbad, Austrian Workers' Compensation Board (AUVA), 8144 Tobelbad, Austria.
Ludwig Boltzmann Institute for Traumatology, 1200 Vienna, Austria.
Medicina (Kaunas). 2023 Sep 25;59(10):1710. doi: 10.3390/medicina59101710.
After major upper-limb amputation, people face challenges due to losing tactile information and gripping function in their hands. While vision can confirm the success of an action, relying on it diverts attention from other sensations and tasks. This case report presents a 30-year-old man with traumatic, complete vision loss and transradial left forearm amputation. It emphasizes the importance of restoring tactile abilities when visual compensation is impossible. A prototype tactile feedback add-on system was developed, consisting of a sensor glove and upper arm cuff with related vibration actuators. We found a 66% improvement in the Box and Blocks test and an overall functional score increase from 30% to 43% in the Southampton Hand Assessment Procedure with feedback. Qualitative improvements in bimanual activities, ergonomics, and reduced reliance on the unaffected hand were observed. Incorporating the tactile feedback system improved the precision of grasping and the utility of the myoelectric hand prosthesis, freeing the unaffected hand for other tasks. This case demonstrated improvements in prosthetic hand utility achieved by restoring peripheral sensitivity while excluding the possibility of visual compensation. Restoring tactile information from the hand and fingers could benefit individuals with impaired vision and somatosensation, improving acceptance, embodiment, social integration, and pain management.
在经历了上肢大截肢手术后,患者会面临因手部丧失触觉信息和握持功能而带来的挑战。虽然视觉可以确认动作的成功,但过度依赖视觉会分散对其他感觉和任务的注意力。本案例报告介绍了一位 30 岁的男性,他因创伤导致完全失明和左前臂经桡骨截肢。该案例强调了在视觉补偿不可能的情况下,恢复触觉能力的重要性。我们开发了一种原型触觉反馈附加系统,由传感器手套和带有相关振动执行器的上臂袖套组成。我们发现,在使用反馈的情况下,Box 和 Blocks 测试的得分提高了 66%,而 Southampton 手评估程序的整体功能评分从 30%提高到了 43%。在双手活动、人体工程学和减少对未受影响的手的依赖方面观察到了定性的改善。引入触觉反馈系统提高了抓握的精度和肌电手假肢的实用性,使未受影响的手可以用于其他任务。该案例表明,通过恢复手部和手指的触觉信息,可以提高假肢的实用性,从而使视力和感觉受损的个体受益,提高其接受度、身体认同感、社会融合度和疼痛管理能力。