Partial-Hand Prosthesis Users Show Improved Reach-to-Grasp Behaviour Compared to Transradial Prosthesis Users with Increased Task Complexity.

Approaches to improve outcomes after upper-extremity amputation remain poorly understood. Examining prosthesis-use at different levels of loss elucidates motor control challenges. Non-amputated participants completed simple and complex reach-to-grasp actions using a body-powered transradial or partial-hand prosthesis simulator. We hypothesised that increased task complexity and participants using a partial-hand device would show greater functional adaptation compared to participants using a transradial device. Partial-hand users demonstrated variable grasp postures and higher reach peak velocities in the complex, but not simple, task. All groups showed decreases in movement duration in the complex task, but only partial-hand users improved in the simple task. These behavioural changes suggest how device level and task may influence prosthesis-use, with relevance to amputation rehabilitation.

Neurorehabilitation in Adults With Traumatic Upper Extremity Amputation: A Scoping Review.

BACKGROUND: Most of the current literature around amputation focuses on lower extremity amputation or engineering aspects of prosthetic devices. There is a need to more clearly understand neurobehavioral mechanisms related to upper extremity amputation and how such mechanisms might influence recovery and utilization of prostheses. OBJECTIVE: This scoping review aims to identify and summarize the current literature on adult traumatic upper limb amputation in regard to recovery and functional outcomes and how neuroplasticity might influence these findings. METHODS: We identified appropriate articles using Academic Search Complete EBSCO, OVID Medline, and Cochrane databases. The resulting articles were then exported, screened, and reviewed based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR) guidelines. RESULTS: Eleven (11) studies met the study criteria. Of these studies, 7 focused on sensory involvement, 3 focused on neuroplastic changes post-amputation related to functional impact, and 1 study focused on motor control and learning post-amputation. Overall, these studies revealed an incomplete understanding of the neural mechanisms involved in motor rehabilitation in the central and peripheral nervous systems, while also demonstrating the value of an individualized approach to neurorehabilitation in upper limb loss. CONCLUSIONS: There is a gap in our understanding of the role of neurorehabilitation following amputation. Overall, focused rehabilitation parameters, demographic information, and clarity around central and peripheral neural mechanisms are needed in future research to address neurobehavioral mechanisms to promote functional recovery following traumatic upper extremity amputation.

The Role of Attention and Saccades on Parietofrontal Encoding of Contextual and Grasp-specific Affordances of Tools: An ERP Study.

The ability to recognize a tool's affordances (how a spoon should be appropriately grasped and used), is vital for daily life. Prior research has identified parietofrontal circuits, including mirror neurons, to be critical in understanding affordances. However, parietofrontal action-encoding regions receive extensive visual input and are adjacent to parietofrontal attention control networks. It is unclear how eye movements and attention modulate parietofrontal encoding of affordances. To address this issue, scenes depicting tools in different use-contexts and grasp-postures were presented to healthy subjects across two experiments, with stimuli durations of 100 ms or 500 ms. The 100-ms experiment automatically restricted saccades and required covert attention, while the 500-ms experiment allowed overt attention. The two experiments elicited similar behavioral decisions on tool-use correctness and isolated the influence of attention on parietofrontal activity. Parietofrontal ERPs (P600) distinguishing tool-use contexts (e.g., spoon-yogurt vs. spoon-ball) were similar in both experiments. Conversely, parietofrontal ERPs distinguishing tool-grasps were characterized by posterior to frontal N130-N200 ERPs in the 100-ms experiment and by saccade-perturbed N130-N200 ERPs, frontal N400 and parietal P500 in the 500-ms experiment. Particularly, only overt gaze toward the hand-tool interaction engaged mirror neurons (frontal N400) when discerning grasps that manipulate but not functionally use a tool - (grasp bowl rather than stem of spoon). Results here detail the first human electrophysiological evidence on how attention selectively modulates multiple parietofrontal grasp-perception circuits, especially the mirror neuron system, while unaffecting parietofrontal encoding of tool-use contexts. These results are pertinent to neurophysiological models of affordances that typically neglect the role of attention in action perception.