Facilitated effects of closed-loop assessment and training on trans-radial prosthesis user rehabilitation

Abstract

(1) Background: Integrating assessment with training helps to enhance precision prosthetic rehabilitation of trans-radial amputees. This study aimed to validate a self-developed closed-loop rehabilitation platform combining accurate measurement in comprehensive assessment and immediate interaction in virtual reality (VR) training in refining patient-centered myoelectric prosthesis rehabilitation. (2) Methods: The platform consisted of two modules, a multimodal assessment module and an sEMG-driven VR game training module. The former included clinical scales (OPUS, DASH), task performance metrics (modified Box and Block Test), kinematics analysis (inertial sensors), and surface electromyography (sEMG) recording, verified on six trans-radial amputees and four healthy subjects. The latter aimed for muscle coordination training driven by four-channel sEMG, tested on three amputees. Post 1-week training, task performance and sEMG metrics (wrist flexion/extension activation) were re-evaluated. (3) Results: The sEMG in the residual limb of the amputees upgraded by 4.8%, either the subjects’ number of gold coins or game scores after 1-week training. Subjects uniformly agreed or strongly agreed with all the items on the user questionnaire. In reassessment after training, the average completion time (CT) of all three amputees in both tasks decreased. CTs of the A1 and A3 in the placing tasks were reduced by 49.52% and 50.61%, respectively, and the CTs for the submitting task were reduced by 19.67% and 55.44%, respectively. Average CT of all three amputees in the ADL task after training was 9.97 s, significantly lower than the pre-training time of 15.17 s. (4) Conclusions: The closed-loop platform promotes patients’ prosthesis motor-control tasks through accurate measurement and immediate interaction according to the sensorimotor recalibration principle, demonstrating a potential tool for precision rehabilitation.