Maas Bart, Van Der Sluis Corry K, Bongers Raoul M
Department of Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.
Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.
Front Rehabil Sci. 2024 Jan 29;5:1353077. doi: 10.3389/fresc.2024.1353077. eCollection 2024.
Controlling a myoelectric upper limb prosthesis is difficult, therefore training is required. Since training with serious games showed promising results, the current paper focuses on game design and its effectivity for transfer between in-game skill to actual prosthesis use for proportional control of hand opening and control of switching between grips. We also examined training duration and individual differences.
Thirty-six participants were randomly assigned to one of three groups: a task-specific serious game training group, a non-task-specific serious game training group and a control group. Each group performed a pre-test, mid-test and a post-test with five training sessions between each test moment. Test sessions assessed proportional control using the Cylinder test, a test designed to measure scaling of hand aperture during grabbing actions, and the combined use of proportional and switch control using the Clothespin Relocation Test, part of the Southampton Hand Assessment Procedure and Tray Test. Switch control was assessed during training by measuring amplitude difference and phasing of co-contraction triggers.
Differences between groups over test sessions were observed for proportional control tasks, however there was lack of structure in these findings. Maximum aperture changed with test moment and some participants adjusted maximum aperture for smaller objects. For proportional and switch control tasks no differences between groups were observed. The effect of test moment suggests a testing effect. For learning switch control, an overall improvement across groups was found in phasing of the co-contraction peaks. Importantly, individual differences were found in all analyses.
As improvements over test sessions were found, but no relevant differences between groups were revealed, we conclude that transfer effects from game training to actual prosthesis use did not take place. Task specificity nor training duration had effects on outcomes. Our results imply testing effects instead of transfer effects, in which individual differences played a significant role. How transfer from serious game training in upper limb prosthesis use can be enhanced, needs further attention.
控制肌电上肢假肢很困难，因此需要进行训练。由于使用严肃游戏进行训练显示出了有前景的结果，本文重点关注游戏设计及其在将游戏内技能转化为实际假肢使用以实现手部张开的比例控制和握姿切换控制方面的有效性。我们还研究了训练时长和个体差异。
36名参与者被随机分配到三个组中的一组：特定任务严肃游戏训练组、非特定任务严肃游戏训练组和对照组。每组在每次测试时刻之间进行五次训练课程，并进行一次预测试、一次中期测试和一次后测试。测试课程使用圆柱体测试评估比例控制，该测试旨在测量抓取动作期间手部开口的缩放比例，并使用衣夹重新定位测试评估比例控制和开关控制的联合使用，衣夹重新定位测试是南安普顿手部评估程序和托盘测试的一部分。在训练期间，通过测量共收缩触发的幅度差异和相位来评估开关控制。
在比例控制任务的测试课程中观察到了组间差异，然而这些结果缺乏系统性。最大开口随测试时刻而变化，一些参与者针对较小物体调整了最大开口。对于比例控制和开关控制任务，未观察到组间差异。测试时刻的影响表明存在测试效应。对于学习开关控制，发现各组在共收缩峰值的相位方面总体有所改善。重要的是，在所有分析中都发现了个体差异。
由于在测试课程中发现了改善，但未揭示组间的相关差异，我们得出结论，游戏训练到实际假肢使用的迁移效应并未发生。任务特异性和训练时长对结果均无影响。我们的结果意味着是测试效应而非迁移效应，其中个体差异起到了重要作用。如何增强上肢假肢使用中严肃游戏训练的迁移效果，需要进一步关注。
