Background Brain plasticity is an important factor in prosthesis usage. This plasticity helps with brain adaptation to learn new movement and coordination patterns needed to control a prosthetic hand. It can be achieved through repetitive muscle training that is usually very exhausting and often results in considerable reduction in patient motivation. Previous studies have shown that a playful concept in rehabilitation can increase patient engagement and perseverance. Objective This study investigated whether the inclusion of video games in the upper limb amputee rehabilitation protocol could have a beneficial impact for muscle preparation, coordination, and patient motivation among individuals who have undergone transradial upper limb amputation. Methods Ten participants, including five amputee participants and five able-bodied participants, were enrolled in 10 1-hour sessions within a 4-week rehabilitation program. In order to investigate the effects of the rehabilitation protocol used in this study, virtual reality box and block tests and electromyography (EMG) assessments were performed. Maximum voluntary contraction was measured before, immediately after, and 2 days after interacting with four different EMG-controlled video games. Participant motivation was assessed with the Intrinsic Motivation Inventory (IMI) questionnaire and user evaluation survey. Results Survey analysis showed that muscle strength and coordination increased at the end of training for all the participants. The results of Pearson correlation analysis indicated that there was a significant positive association between the training period and the box and block test score (r8=0.95, P<.001). The maximum voluntary contraction increment was high before training (6.8%) and in the follow-up session (7.1%), but was very small (2.1%) shortly after the training was conducted. The IMI assessment showed high scores for the subscales of interest, perceived competence, choice, and usefulness, but low scores for pressure and tension. Conclusions This study demonstrated that video games enhance motivation and adherence in an upper limb amputee rehabilitation program. The use of video games could be seen as a complementary approach for physical training in upper limb amputee rehabilitation.

Body-powered prostheses are known for their advantages of cost, reliability, training period, maintenance, and proprioceptive feedback. This study primarily aims to analyze the work related to the improvement of upper limb body-powered prostheses prior to 2016. A systematic review conducted via the search of the Web of Science electronic database, Google Scholar, and Google Patents identified 155 papers from 1921 to 2016. Sackett's initial rules of evidence were used to determine the levels of evidence, and only papers categorized in the design and development category and patents were analyzed. A total of 40 papers in the sixth level of "Design and Development" of an upper limb body-powered prosthesis were found. Approximately 81% were categorized under mechanical alteration. Most papers were patent-type documents (48%), with the Journal of Rehabilitation Research and Development publishing most of the articles related to the design and development of body-powered prostheses. Papers in the scope of the study were published once every 3 years in almost a century, proving that only a few studies were conducted to improve body-powered arms compared with myoelectric technology. Further research should be carried out mainly in areas that have received less attention.

Previous studies have demonstrated the potential of virtual reality as an effective teaching tool for motor training. Despite the growing interest in this field, only a few studies have determined the validity of the tasks made in virtual environments to real physical environments. This case-control study compares the score of pick and place activity in the real and virtual environment by using the box and blocks test setup on 4 able-bodied and 4 transradial amputees (2 myoelectric prosthetic users and 2 nonprosthetic users). This study integrates the traditional Box and Blocks Test mechanics into gameplay by using the Leap Motion controller and Oculus Rift headset. The participants were instructed to complete the test in both environments randomly for 10 sessions, with 30 minutes of training in each session. Pearson's correlation interpretation was conducted to investigate the relation between the test's score with the training duration, also the score obtained in the real and virtual environment. Independent samples t-test was also carried out to compare the score from the different test environments. All participants showed a greater percentage change of test score in the virtual version and better performance was achieved with increasing training duration. Both environments were positively correlated. However, there was a significant difference in the test score obtained in the real and virtual environment for able-bodied t(9)=18.19, p<0.05 and myoelectric prosthetic user t(9)=4.51, p<0.05, but not for the non-prosthetic user. This study has demonstrated that two different environments showed significantly comparable results in pick and place tasks by individuals with different abilities.

While considering the importance of the interface between amputees and prosthesis sockets, we study an anthropomorphic prosthesis socket whose size can be dynamically changed according to the requirements of the residual limb. First, we introduce the structure and function of the anthropomorphic prosthesis socket. Second, we study the dynamic model of the prosthesis system and analyze the dynamic characteristics of the prosthesis socket system, the inputs of an oscillometric pump, and the control mechanism of force-sensitive resistor (FSR) pressure signals. Experiments on 10 healthy subjects using the designed system yield an average detection result between 102 and 112 kPa for the FSR pressure sensor and 39 and 41 kPa for the oscillometric pump. Results show the function of the FSR pressure signal in maintaining the contact pressure between the sockets and the residual limb. The potential development of an auto-adjusted socket that uses an oscillometric pump system will provide prosthetic sockets with controllable contact pressure at the residual limb. Moreover, this development is an attractive research area for researchers involved in rehabilitation engineering, prosthetics, and orthotics.

There are a number of prosthetic terminal devices which offer functional restoration to individuals with upper limb deficiencies. Hosmer and Ottobock are major commercial hook providers for prosthetic terminal devices. The concern of this paper is to analyse the voluntary opening (VO) Ottobock model 10A18 and Hosmer model 99P hooks (one band) during opening operation and to find out favourable features in the design. Two tests were conducted to analyse the performance of both hooks. The first test used a simple bench tool to investigate cable excursion and hook opening angle and the second test used force sensor to find out the force supplied at a different hook opening angle. The study found that the average cable excursion for both hooks is approximately 30% less than the hook's opening span with the force at the hook's tip section being inversely proportional to the force at the lateral section. Ottobock 10A18 has a better control for grasping larger objects, while Hosmer 99P has the highest average force at the tip section but yet less efficient in generating adequate force for activities of daily living. Favourable features identified are low cable excursion per hook opening span and balance lateral to hook tip pinch force.