Category: Limb Restoration Rehabilitation; Clinical Practice (assessment, diagnosis, treatment, knowledge translation/EBP, implementation science, program development)
Objective : To investigate differences in dedication of visual attention while using direct (DC) or pattern recognition (PRC) myoelectric control of a prosthetic terminal device.
Design : Single case-study, crossover trial
Setting : University
Participants (or Animals, Specimens, Cadavers) : Purposive sample. Two individuals were screened; one completed the protocol. Eligible participants were at least 18 years old, had a unilateral wrist disarticulation or transradial amputation, and had viable myoelectric electrode sites. The order of interventions was randomized.
Interventions : Both DC and PRC use electromyographic data collected from electrodes placed on the skin to control a prosthetic terminal device. The subject completed a series of motions in multiple degrees of freedom that required intentional and moderated use of residual musculature to control a prosthetic terminal device. Four testing sessions were completed using each intervention. The subject used each system for approximately 6 hours in total.
Main Outcome Measure(s) : 5-point visual Likert-type scale, subject-reported questionnaire, visual gaze tracking
Results : Significant increases in testing time with gaze at the 'Task' area of interest were detected in the third versus first (p = 0.0025) and fourth versus first (p = 0.0052) sessions using DC. Significantly more testing time was spent with gaze at the 'Task' area of interest for PRC than for DC (p=22e-16). The subject performed significantly fewer gaze transitions for the fourth versus first (p = 0.0003) and fourth versus second (p=0.038) sessions using DC. Significantly fewer gaze transitions occurred on average per testing session for PRC than for DC (p = 1.33e-13). Statistics are reported at a 95% CI.
Conclusions : These results indicate differences in dedication of visual attention associated with learning to use a myoelectric control system, as well as differences in gaze behavior between two varieties of myoelectric control of a prosthetic terminal device. This study acts as a pilot and protocol validation for future study in the topic area.