Changes in Sensorimotor Cortical Activation in Children Using Prostheses and Prosthetic Simulators

Abstract

This study aimed to examine the neural responses of children using prostheses and prosthetic simulators to better elucidate the emulation abilities of the simulators. We utilized functional near-infrared spectroscopy (fNIRS) to evaluate the neural response in five children with a congenital upper limb reduction (ULR) using a body-powered prosthesis to complete a 60 s gross motor dexterity task. The ULR group was matched with five typically developing children (TD) using their non-preferred hand and a prosthetic simulator on the same hand. The ULR group had lower activation within the primary motor cortex (M1) and supplementary motor area (SMA) compared to the TD group, but nonsignificant differences in the primary somatosensory area (S1). Compared to using their non-preferred hand, the TD group exhibited significantly higher action in S1 when using the simulator, but nonsignificant differences in M1 and SMA. The non-significant differences in S1 activation between groups and the increased activation evoked by the simulator’s use may suggest rapid changes in feedback prioritization during tool use. We suggest that prosthetic simulators may elicit increased reliance on proprioceptive and tactile feedback during motor tasks. This knowledge may help to develop future prosthesis rehabilitative training or the improvement of tool-based skills.

Reimagining Prosthetic Control: A Novel Body-Powered Prosthetic System for Simultaneous Control and Actuation

“…This is particularly promising for UL-deficient children and adolescents, as their prosthetic operating space should not be limited as they grow and develop. Prosthesis use in children has been found to affect the development of their brain, as well as their motor control strategies [72][73][74][75][76]. This could have implications for long-term prosthetic outcomes.…”

A multiarticulate pediatric prosthetic hand for clinical and research applications

“…Although control of dexterous prostheses for adults with congenital upper limb deficiencies has been investigated ( Kryger et al, 2011 ), it is uncertain how these findings may translate to developing children. Furthermore, limited work has been done to illustrate changes in cortical activation during prosthesis control ( Da Paz and Braga, 2007 ; Copeland et al, 2021 ). Addressing these knowledge gaps requires rigorous scientific investigations and supporting research platforms; hardware such as dexterous child-sized prostheses with open access to its programming and the mechanical capabilities to interact with daily objects to perform clinical or research-based activities.…”