Amputation of Upper Limb Below Elbow, Prosthesis User
Conditions
Keywords
Imagery, Amputee, Prosthetic, Functional, Myoelectric
Brief summary
The purpose of this study is to evaluate the motor imagery ability in transradial amputees using myoelectric prosthesis, compare it with the control group and investigate its effect on functionality and proprioception.
Detailed description
In the sensory and motor homunculus, the upper extremity, especially the hand, areas cover a larger area. Morphological changes occur in the body in amputees due to upper extremity amputation. In addition, neural restructuring occurs due to the lack of sensory input and visual feedback. These neurophysiological changes experienced in amputees affect the cortical areas of the brain. This situation can also negatively affect motor imagery ability. For this reason, upper extremity prosthesis systems with different control mechanisms have been developed. In one of the developed systems, myoelectric prostheses, since the signals received with electrodes due to muscle contraction provide sensory input to amputees, known that it increases synaptic sprouting in the brain and improves motor imagery ability. There are studies that use motor imagery in stroke, spinal cord injury, Parkinson's disease, postoperative anterior cruciate ligament injuries, cervical and lumbar region pain problems. In addition, it focused on motor imagery after amputation and emphasized that the evidence on whether motor imagery ability is impaired in amputees is not sufficient. In a study, it was found that the use of upper extremity prosthesis increases the hand mental rotation ability and this situation is related to the body integrity of amputees with the use of prosthesis. After investigatorsexamination and screening, to the best of investigators knowledge, no study was found that evaluated the motor imagery ability of transradial amputees using myoelectric controlled prosthesis and examined its effect on functionality. Therefore, the aim of investigators study is to evaluate the motor imagery ability in transradial amputees using myoelectric prosthesis, compare it with the control group and investigate its effect on functionality and proprioception. Transradial amputees using myoelectric prosthesis and the control group (healthy individuals) between the ages of 22-65 will be included in the study. Demographic information of all participants to be included in the study will be recorded with the "Case Assessment Form". Standardized Mini Mental Test (SMMT) to evaluate the cognitive status of individuals, Beck Depression Inventory (BDI) to evaluate depression symptoms, Movement Imagery Questionnaire-3 to evaluate motor imagery ability, Mental Chronometry Test (MKT) measuring motor imagery time, "Orientate" mobile application to evaluate hand mental rotation task performance, Box and Block Test to evaluate gross motor hand skills and functionality, Jebsen Taylor Hand Function Test (JTEFT) to measure upper extremity functions,Disabilities of the Arm Shoulder and Hand (DASH) for upper extremity functional assessment, Modified Functional Reach Test (MFUT) to measure dynamic balance of the trunk, and Joint Position Sense measurement to evaluate proprioceptive sense will be used. All data will be evaluated by statistical analysis methods.
Interventions
OTHERNo intervention
Sponsors
Medipol University
Study design
Observational model
OTHER
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
Amputee group inclusion criteria * Being an amputee using a unilateral transradial and myoelectric prosthesis * Having at least 6 months of prosthesis experience * Having a maximum score of 15 on the Beck Depression Inventory * Having a minimum score of 26 on the Standardized Mini Mental Test * Being willing to participate in the study Control Group inclusion criteria * Being between the ages of 18-65 * Having a minimum score of 26 on the Standardized Mini Mental Test * Having signed the Informed Voluntary Consent Form * Having a maximum score of 15 on the Beck Depression Inventory * Being literate
Exclusion criteria
Amputee group
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Movement Imagination Questionnaire-3 | immediately after screening | In order to determine the imagery ability of all individuals included in the amputee and control groups, the "Movement Imagery Questionnaire-3" developed and validated and validated in Turkish will be used (internal consistency coefficient: 0.87). With the 12 items in this questionnaire, internal visual imagery, external visual imagery and kinesthetic imagery abilities will be assessed through four actions each. The actions will be actively performed by the individuals at the beginning. Then, they were asked to perform these actions as mental tasks. These mental tasks were scored using a seven-point Likert scale (1: very difficult to see, feel; 7: very easy to see, feel). In the calculation of the score, the average score of the four relevant actions will be taken for each of the three sub-dimensions. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Orientate Mobile Application | immediately after screening | It is used for the purpose of evaluating mental rotation. It is based on the principle of showing individuals hand images from different angles with the application. There are a total of 25 hand images for the test. Participants will be asked to sit comfortably in a chair in front of a table and the mobile application will be opened and the test will be applied. Participants will be asked to decide which of the images is the right and which is the left hand photo as soon as possible. At the end of the test, the application will show the number of correct answers, the number of incorrect answers, the number of missed answers and the time to complete the test. The accuracy rates will also be recorded by comparing the number of correct answers to the total number of images. |
| Box and Block Test | immediately after screening | The box and block test is a method used to evaluate gross motor skills and measure functionality. For the test, 150 blocks with dimensions of 2.5 cm and a box divided into two compartments are used. Participants will be asked to take the blocks one by one from the box consisting of two compartments on a table and see how many blocks they can put into the empty compartment placed in the other compartment in 60 seconds, and the results will be noted. In order for the evaluation to be accurate, the process will be repeated three times and the average of the recorded evaluation will be taken. |
| Jebsen Taylor Hand Function Test (JTEFT) | immediately after screening | It is a performance-based test developed in 1969 that includes movements in daily life activities. It includes different types of grip and evaluates the speed of individuals in these tasks. The materials for the test are standardized and can be easily accessed in the clinic. Participants will be asked to do 7 different tasks in the test content. These tasks are writing, turning cards, picking up objects, eating, stacking checkers, picking up light wide objects and picking up heavy wide objects. Participants will be asked to do each task separately with both hands. The test score will be calculated by recording the time it takes for participants to complete the tasks. |
| Modified Functional Reach Test (MFUT) | immediately after screening | It is a test developed to evaluate the dynamic balance and functionality of the trunk. The distance the trunk can extend forward and sideways without losing balance in a sitting position is measured. The participants will be measured next to a wall with participants ankles, knees, and hips at 90° flexion and participants feet in full contact with the ground. In the relevant position, the arm will be extended parallel to the wall, then extended forward and sideways, and the distance in between will be recorded in cm with the help of a tape measure. |
| Disabilities of the Arm Shoulder and Hand (DASH) | immediately after screening | It is a scale that measures the activity and participation limitations of the upper extremity. It is based on the principle of self-assessment of the results. In 2006, the validity and reliability study of the survey in Turkish was conducted. There are 11 questions in the survey. It aims to question the difficulties that individuals have during participants daily living activities. The answers are scored from good to bad on a Likert scale, with each answer being scored from 1 to 5. The survey has options such as 1 = no difficulty, 2 = mild difficulty, 3 = moderate difficulty, 4 = extreme difficulty, and 5 = unable to do at all. |
| Joint Position Sense Measurement | immediately after screening | Joint position sense is evaluated with the aim of measuring the ability of a certain joint angle to be repeated in an individual. This measurement can be applied passively-actively or with eyes closed-open. This test reveals the acuity of defining a certain angle in joints. Considering the amputation level of transradial amputees included in investigators study, shoulder and elbow joint position sense of all participants will be measured. |
| Mental Chronometry Test | immediately after screening | It is known as another method that can be used to evaluate motor imagery ability. Mental chronometry is based on the principle of comparing the time it takes to perform a movement with the time it takes to mentally image the same movement. This test provides more objective results than survey applications. The Mental Chronometry test will be evaluated in investigators study with the help of the Box and Block Test. Participants will be asked to imagine this task after performing the box block test performance. The time required to collect 15 blocks will be recorded, unlike the normal procedure of the box block test. Purpose is evaluate mental chronometry ability rather than gross manual dexterity. |
Countries
Turkey (Türkiye)
Contacts
STUDY_DIRECTORAyşe Yazgan
https://www.medipol.edu.tr/
Outcome results
None listed