334 - Functional Improvements Following Interlimb Training for Upper Extremity Prosthesis Use

Objectives: Empirical approaches to functional rehabilitation during the acute and sub-acute stages following upper limb amputation surgery remain an area of need, particularly at varying levels of amputation. Interlimb training (ILT) is a promising approach that enables prosthesis training on the unaffected limb, via a simulator, before receiving a prosthesis for use on the affected limb. This may reduce prosthesis abandonment and the development of negative compensatory strategies. This study seeks to evaluate functional outcomes of prosthesis users following an ILT training regimen. Quantifying the role of ILT in functional adaptation to prostheses use is beneficial to our understanding of its practical utility in the clinical rehabilitation setting as it pertains to different levels of upper-extremity amputation.

Design: Persons with sound limbs performed reach-to-grasp tasks while wearing either a transradial (TrPS) or partial-hand prosthesis simulator (PhPS) in a 5-day ILT paradigm. The first day of the paradigm consisted of participants using a prosthesis simulator on their right limb to complete motor execution testing tasks. For the following three days, participants wore the simulator on their left limb to complete training tasks. Participants returned on the final day for testing using the prosthesis simulator again on their right limb. This allowed for a pre-test/post-test comparison following ILT.

Results: Both partial-hand and transradial device users showed significant increases in reach peak velocity (9% and 8.8% increase, respectively), while only partial-hand users showed significant decreases in reach duration (14% decrease). Overall, the most notable and consistent effects were seen in partial-hand users.

Conclusions: These results suggest interlimb training for prosthesis use may be an efficacious approach to rehabilitation therapy in persons with upper limb amputation, especially in cases of partial-hand amputation. Future work should involve a longer translational study in persons with upper limb loss to examine the lasting effects of ILT.