Agenesis of Upper Limb, Amputation of Upper Limb
Conditions
Keywords
amputation, amputation of upper limb, prosthesis
Brief summary
Amputation of an upper limb results in a disruption of the sensorimotor loop and a reorganization of the nervous system, leading to the emergence of a phantom limb and the adaptation of compensatory motor strategies. This project aims to leverage these phenomena (induced sensations, phantom mobility, and compensations) to improve control, sensory feedback, and the appropriation of prostheses, in order to reduce cognitive load and musculoskeletal disorders.
Interventions
OTHERCaracterisation
The objective of this phase is to identify, from a population of individuals with upper limb amputations, a sufficient number of participants who experience non-painful phenomena related to their phantom limb (sensations, mobility, etc.) prior to the subsequent phases. This phase takes the form of a semi-structured individual interview conducted by one of the study investigators.
OTHERMapping
The objective of this phase is to study the phenomenon of induced phantom sensations in individuals who reported experiencing such sensations during the previous phase. This phase involves a systematic exploration of the areas of the residual limb whose stimulation induces non-painful phantom sensations, as well as the type of sensations thus induced.
OTHERPhantom sensations
The goal of this phase is to determine whether stimulation of the residual limb that induces sensations in the phantom limb can help people with lower-limb amputations use their prostheses more effectively.
OTHERClassification
The objective of this phase is to characterize the influence of voluntary movements of the residual limb on the myoelectric activity associated with phantom limb mobility. Myoelectric activity and cognitive load will be assessed
OTHERProsthetic control
The objective of this phase is to evaluate the performance of a prosthetic control method based on phantom limb movement in individuals with upper limb amputations. The principle behind this method is to control the movements of the prosthesis using the corresponding movements of the phantom limb, by utilizing the myoelectric activity that can be measured on the residual limb during voluntary phantom limb movements.
OTHERmotor compensations
The objective of this phase is to characterize and quantify the compensatory movements associated with the use of a conventional myoelectric upper limb prosthesis. The participant will perform the manipulation tasks defined in the SHAP method, as well as the clothespin displacement test.
OTHERUse of motor reorganization and compensation
The objective of this phase is to evaluate the performance of a prosthesis control method based on the compensatory movements associated with the use of an upper limb prosthesis. During this phase, participants will not use their personal prostheses but rather an experimental prosthesis developed by the investigators specifically for this study. The experimental prosthesis will be programmed to implement the control method based on compensatory movements, which is the focus of this evaluation.
Sponsors
Union de Gestion des Etablissements des Caisses d'Assurance Maladie - Nord Est
Institut des Sciences du Mouvement
Institut des Systèmes Intelligents et de Robotique
Laboratoire des Sciences du Numérique de Nantes
Institut de Recherche en Informatique et Systèmes Aléatoires
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
BASIC_SCIENCE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* people aged 18 or more * amputation or agenesis of one uper limb, above the wrist or higher * understanding of the French language and the ability to express onself in that language (for semi-structured interviews) * affiliation to a social security programm
Exclusion criteria
* history of progressive psychiatric or neurological disorders or disorders with residual effects * pregnant or breastfeeding woman * minor * an adult under legal guardianship * pain influencing movement (trunk, residual limb, phantom limb, contralateral limb)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Characterization of phantom limb | Baseline (Phase 1 session) ; optional repeat assessment at 6 months | Semi-structured interview to elicit patients' descriptions of phantom sensations |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| NASA TLX Score | Administered at the end of each experimental sequence, up to 6 months | The cognitive load associated with the various tasks will be assessed. The higher the score, the greater the cognitive load. |
| Southampton Hand Assessment Procedure (SHAP) | At each evaluation session, up to 6 month | A standardized, timed questionnaire-led assessment of pathological hand function. It evaluates overall hand function and dexterity through 26 tasks, including 12 abstract object manipulations and 14 activities of daily living (ADL). Tasks are timed to calculate an overall Index of Function (IoF) scored out of 100, where higher scores reflect better hand function. |
| Clothespin Relocation Test (CRT) | At each evaluation session, up to 6 months | A functional upper limb assessment measuring manual dexterity and proximal control. Participants are timed while transferring a set number of clothespins from a horizontal bar to a vertical bar (and/or vice versa) against varying spring resistances. Performance is measured by the total time taken (in seconds) to complete the task, where a shorter duration indicates better motor efficiency and coordination |
Countries
France
Contacts
CONTACTAmélie Touillet
CONTACTJonathan Pierret, PhD
Outcome results
None listed