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.
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
history of progressive psychiatric or neurological disorders or disorders with residual effects
pregnant or breastfeeding woman
minor
an adult under legal guardianship
Single group
Caracterisation
Other interventionThe 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.
Mapping
Other interventionThe 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.
Phantom sensations
Other interventionThe 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.
Classification
Other interventionThe 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
Prosthetic control
Other interventionThe 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.
motor compensations
Other interventionThe 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.
Use of motor reorganization and compensation
Other interventionThe 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.
Characterization of phantom limb
Semi-structured interview to elicit patients' descriptions of phantom sensations
NASA TLX Score
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)
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)
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
Mapping of induced sensations
Mapping the relationships between real members and ghost members
Assessment of the effects of phantom sensation induction
Whenever the participant controls the virtual hand, its movements (i.e., degree of opening and closing) will be recorded. The participant's performance will be measured by the rate of correctly identifying the stiffer object for each pair of objects presented.
Classification of myoelectric activity associated with phantom limb movements
Classification of recorded myoelectric activity for residual and intact limbs
Click on the lead sponsor to view all of their trials.
Union de Gestion des Etablissements des Caisses d'Assurance Maladie - Nord Est
Lead sponsor
Institut des Sciences du Mouvement
Collaborator
Institut des Systèmes Intelligents et de Robotique
Collaborator
Laboratoire des Sciences du Numérique de Nantes
Collaborator
Institut de Recherche en Informatique et Systèmes Aléatoires
Collaborator
