Presentation Title

THE EFFECT OF A TRAINING INTERVENTION ON BIMANUAL SYNCHRONY AND MUSCULAR CO-CONTRACTION DURING USE OF AN UPPER LIMB PROSTHESIS

Author ORCID Identifier

0000-0002-7605-5126

Advisor Information

Jorge M. Zuniga

Presentation Type

Poster

Start Date

26-3-2021 12:00 AM

End Date

26-3-2021 12:00 AM

Abstract

An estimated 35-58% of children with upper limb reductions (ULR) reject their prosthesis due to various factors including weight, discomfort, and lack of functionality [1-2]. This study was designed to assess the impact of training on functionality as measured by bimanual synchrony and muscular co-contractions with a body-powered prosthesis. A 19-year-old female with a congenital left hand ULR was recruited for the case study. Her bimanual synchrony and muscular co-contraction were measured before and after an 8-week training intervention. The home intervention included activities of daily living such as cutting pieces of paper, using utensils, and holding a tray. Co-contraction values were expressed as a Coactivation Index (CI) and calculated as a percentage of antagonist over agonist activity during maximal voluntary contraction. Bimanual synchrony was calculated as the difference in time between the limbs. During MVC for flexion, the CI for the affected limb (M ± SD) were 31.10 ± 1.54 at Baseline and 23.11 ± 9.98 at Follow-Up. During extension, the CI for the unaffected limb were 17.33 ± 1.50 and 25.43 ± 1.94 respectively. The CI values for the affected hand indicate that the participant has a higher percentage of flexor activity following the training. At Baseline, task synchrony between hands was -0.03 ± 0.04 seconds. At Follow-Up, synchrony was 0.04 ± 0.08 seconds, indicating a tendency to lead with the non-affected hand during tasks. Further assessment of functionality should assess participant perceived functionality with the prosthetic.

Additional Information (Optional)

[1] L. Resnik et al., “Advanced upper limb prosthetic devices: Implications for upper limb prosthetic rehabilitation,” Archives of Physical Medicine and Rehabilitation, vol. 93, no. 4. W.B. Saunders, pp. 710–717, 2012, doi: 10.1016/j.apmr.2011.11.010.

[2] E. A. Biddiss and T. T. Chau, “Upper limb prosthesis use and abandonment: A survey of the last 25 years,” Prosthet. Orthot. Int., vol. 31, no. 3, pp. 236–257, 2007, doi: 10.1080/03093640600994581.

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Mar 26th, 12:00 AM Mar 26th, 12:00 AM

THE EFFECT OF A TRAINING INTERVENTION ON BIMANUAL SYNCHRONY AND MUSCULAR CO-CONTRACTION DURING USE OF AN UPPER LIMB PROSTHESIS

An estimated 35-58% of children with upper limb reductions (ULR) reject their prosthesis due to various factors including weight, discomfort, and lack of functionality [1-2]. This study was designed to assess the impact of training on functionality as measured by bimanual synchrony and muscular co-contractions with a body-powered prosthesis. A 19-year-old female with a congenital left hand ULR was recruited for the case study. Her bimanual synchrony and muscular co-contraction were measured before and after an 8-week training intervention. The home intervention included activities of daily living such as cutting pieces of paper, using utensils, and holding a tray. Co-contraction values were expressed as a Coactivation Index (CI) and calculated as a percentage of antagonist over agonist activity during maximal voluntary contraction. Bimanual synchrony was calculated as the difference in time between the limbs. During MVC for flexion, the CI for the affected limb (M ± SD) were 31.10 ± 1.54 at Baseline and 23.11 ± 9.98 at Follow-Up. During extension, the CI for the unaffected limb were 17.33 ± 1.50 and 25.43 ± 1.94 respectively. The CI values for the affected hand indicate that the participant has a higher percentage of flexor activity following the training. At Baseline, task synchrony between hands was -0.03 ± 0.04 seconds. At Follow-Up, synchrony was 0.04 ± 0.08 seconds, indicating a tendency to lead with the non-affected hand during tasks. Further assessment of functionality should assess participant perceived functionality with the prosthetic.