Researchers at the University of Missouri developed a technique to use wearable sensors to gather data on how people who have traumatic hand amputations use a prosthesis or a transplanted hand.
For the study, the research team collected data continuously over three days as participants went about their daily activities. They wore four different sensors—two on the wrists of the prosthesis or transplanted hand, two on the uninjured limb, and one on each upper arm.
To date, the data indicates that people with a transplanted hand demonstrate a more balanced use of their hands than those who use a prosthesis.
Scott Frey, PhD, the Miller Family chair in cognitive neuroscience in the Department of Psychological Sciences, and the Department of Physical Medicine and Rehabilitation at the university, is leading the study.
“Most activities performed by a typical adult involve a fairly evenly balanced reliance on both hands,” Frey said. “Over the course of a normal day, roughly 55 percent of people’s activities involve the dominant hand and 45 percent involve the non-dominant hand. Now we have evidence that shows experienced prosthesis users rely on their prosthetic hand during about 20 percent of daily activities and use their uninjured limb for the remaining 80 percent. Hand transplant recipients exhibit a more balanced pattern of limb use that is closer to what we see in healthy adults, although not quite at the 55 percent/45 percent split.”
Frey said the findings could help physicians and other medical professionals personalize treatment options to meet a patient’s individual needs based on his or her daily routine, noting that a hand transplant comes with significant risks, such as developing certain infections and cancers from the lifetime use of immunosuppressants needed to help keep the body from rejecting the new hand.
“We can bring people into a clinic or laboratory setting, and measure how they are doing with a prosthetic or hand transplant, but these observations are typically made under optimal and artificial conditions, and therefore might not accurately show us how people are truly functioning during their everyday lives,” Frey said. “These sensors, which continuously record movements over multiple days while people go about their lives, have the ability to revolutionize treatments by providing real-world data that will help us develop personalized approaches to treat traumatic hand loss.”
Frey’s approach is also being used to investigate patterns of recovery in individuals with severe upper-limb injuries who are at increased risk of developing chronic one-handedness through learned disuse of the injured limb. That project, scheduled to be completed in fall 2024, is being supported by a $1.5 million grant from the United States Department of Defense Restoring Warfighters with Neuromusculoskeletal Injuries Research Award, and includes collaborators from the schools of medicine at Johns Hopkins University, Ohio State University and Washington University in St. Louis.
The study, “Greater and more natural use of the upper limbs during everyday life by former amputees versus prosthesis users” was published in Neurorehabilitation and Neural Repair.
Editor’s note: This story was adapted from materials provided by the University of Missouri.
