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  • 1.
    Gatzounis, Rena
    et al.
    Research Group Experimental Health Psychology, Department of Clinical Psychological Science, Maastricht University, The Netherlands; Research Group Health Psychology, Faculty of Psychology & Educational Sciences, University of Leuven, Belgium.
    Crombez, Geert
    Department of Experimental-Clinical & Health Psychology, Faculty of Psychology & Educational Sciences, Ghent University, Belgium.
    Schrooten, Martien G. S.
    Örebro University, School of Law, Psychology and Social Work. Research Group Health Psychology, Faculty of Psychology & Educational Sciences, University of Leuven, Belgium.
    S. Vlaeyen, Johan W.
    Research Group Experimental Health Psychology, Department of Clinical Psychological Science, Maastricht University, The Netherlands; Research Group Health Psychology, Faculty of Psychology & Educational Sciences, University of Leuven, Belgium.
    A break from pain!: Interruption management in the context of pain2019In: Pain management, ISSN 1758-1869, Vol. 9, no 1, p. 81-91Article in journal (Refereed)
    Abstract [en]

    Activity interruptions, namely temporary suspensions of an ongoing task with the intention to resume it later, are common in pain. First, pain is a threat signal that urges us to interrupt ongoing activities in order to manage the pain and its cause. Second, activity interruptions are used in chronic pain management. However, activity interruptions by pain may carry costs for activity performance. These costs have recently started to be systematically investigated. We review the evidence on the consequences of activity interruptions by pain for the performance of the interrupted activity. Further, inspired by literature on interruptions from other research fields, we suggest ways to improve interruption management in the field of pain, and provide a future research agenda.

  • 2.
    Lindner, Helen Y
    et al.
    Örebro University, School of Health Sciences.
    Buer, Nina
    Örebro University, School of Health Sciences.
    Hermansson, Liselotte
    Örebro University, School of Health Sciences. University Health Care Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; Dept. of Prosthetics and Orthotics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden .
    Compensatory Movement in Upper Limb Prosthesis Users during Activity Performance2019In: ISPO 17th World Congress:  Basics to Bionics: Abstract Book, ISPO , 2019, p. -512Conference paper (Refereed)
    Abstract [en]

    BACKGROUND: Low dexterity of conventional two-function (open, close) myoelectric hand prostheses with limited wrist movement often leads to compensatory shoulder and elbow movements, e.g. excess shoulder abduction and elbow flexion. Compensatory movements may lead to musculoskeletal pain [1] and it is thus important to identify prosthesis users with compensatory movements and to develop preventive treatments for musculoskeletal pain.

    AIM: The study aim was to measure and compare compensatory movements during activity performance among upper limb prosthesis users with different levels of myoelectric control.

    METHOD: Twenty-seven users of conventional myoelectric hand prosthesis performed the Assessment of Capacity for Myoelectric Control (ACMC) at the Örebro Limb Deficiency and Arm Prosthesis Centre. The performances were recorded and analyzed with Dartfish motion capture video analysis software. The software was used to track and measure the maximum angles for shoulder abduction and elbow flexion at the non-prosthetic and prosthetic sides during the activity performance. Two independent raters used Dartfish to analyze 10 videos and Intra-class Correlation Coefficient (ICC) was used to calculate inter-rater reliability. The ability to control a myoelectric prosthetic hand was assessed by the ACMC.

    RESULTS: The within-individual differences for shoulder abduction ranged from 2° to 52° and for elbow flexion from 1° to 66°. When compared between prosthetic and non-prosthetic side, larger differences in shoulder abduction and elbow flexion were found among the users with ACMC ≤ 0 than users with ACMC > 0 (Fig.1a). When comparing the within-individual side differences between prosthesis users with ACMC ≤0 and users with ACMC >0, a significant angle difference was found in the elbows (p=0.03) but not in the shoulders (p=0.34) (Fig.1b). Inter-rater reliability between the two independent raters was excellent (ICC 0.91).

    DISCUSSION AND CONCLUSION: Compensatory elbow movements during activity performance are higher in upper limb prosthesis users with low level of myoelectric control. Prevention for musculoskeletal pain should consist of both training for improved prosthetic control and improved prosthetic use in activity performance. Measurement of compensatory movements can help to identify amputees with frequent compensatory movements. Future studies are needed to investigate the effect of ability to control myoelectric prosthesis on musculoskeletal pain.

    REFERENCES [1] Jones LE, Davidson JH. Prosthet Orthot Int 1999; 23(1):55-8.

    ACKNOWLEDGEMENTS This study was supported financially by the Norrbacka-Eugenia Foundation.

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    Compensatory Movement in Upper Limb Prosthesis Users during Activity Performance
  • 3.
    Lindner, Helen Y
    et al.
    Örebro University, School of Health Sciences.
    Hill, Wendy
    Institute of Biomedical Engineering, UNB, Fredericton, Canada.
    Hermansson, Liselotte
    Örebro University, School of Health Sciences. University Health Care Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; Dept. of Prosthetics and Orthotics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Lilienthal, Achim J.
    Örebro University, School of Science and Technology.
    Cognitive load and compensatory movement in learning to use a multi-function hand2019In: ISPO 17th World Congress: Basics to Bionics: Abstract Book, ISPO , 2019, p. 52-52Conference paper (Refereed)
    Abstract [en]

    BACKGROUND: Recent technology provides increased dexterity in multi-function hands with the potential to reduce compensatory body movements. However, it is challenging to learn how to operate a hand that has up to 36 grips. While the cognitive load required to use these hands is unknown, it is clear that if the cognitive load is too high, the user may stop using the multi-functional hand or may not take full advantage of its advanced features.

    AIM: The aim of this project was to compare cognitive load and compensatory movement in using a multi-function hand versus a conventional myo hand.

    METHOD: An experienced prosthesis user was assessed using his conventional myo hand and an unfamiliar iLimb Ultra hand, with two-site control and the same wrist for both prostheses. He was trained to use power grip, lateral grip and pinch grip and then completed the SHAP test while wearing the Tobii Pro 2 eye-tracking glasses. Pupil diameter (normal range: 2-4mm during normal light) was used to indicate the amount of cognitive load.[1] The number of eye fixations on the prosthesis indicate the need of visual feedback during operation. Dartfish motion capture was used to track the maximum angles for shoulder abduction and elbow flexion.

    RESULTS: Larger pupils were found in the use of Ilimb ultra (2.6-5.6mm) than in the use of conventional myo hand (2.4-3.5mm) during the SHAP abstract light tests. The pupils dilated most often during changing grips, e.g. switching to pinch grip for the tripod task (from 2.7 to 5.6mm). After training of using power grip and pinch grip repeatedly, the maximum pupil diameter decreased from 5.6 to 3.3mm. The number of eye fixations on the I-limb ultra (295 fixations) were also higher than on the conventional myo-hand (139 fixations). Smaller shoulder abduction and elbow flexion were observed in the use of I-limb ultra (16.6°, 36.1°) than in the use of conventional myo hand (57°, 52.7°).

    DISCUSSION AND CONCLUSION: Although it is cognitively demanding to learn to use a multi-function hand, it is possible to decrease this demand with adequate prosthetic training. Our results suggest that using a multi-function hand enables reduction of body compensatory movement, however at the cost of a higher cognitive load. Further research with more prosthesis users and other multi-function hands is needed to confirm the study findings.

    REFERENCES [1] van der Wel P, van Steenbergen H. Psychon Bull Rev 2018; 25(6):2005-15.

    ACKNOWLEDGEMENTS: This project was supported financially by Norrbacka-Eugenia Foundation, Promobilia Foundation and Örebro University.

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    Cognitive Load and Compensatory Movement in Learning to use a Multi-Function Hand
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