Phd Ceremomy Ms. H. Bouwsema: Learning to handle a myoelectric upper-limb prosthesis. The development of an evidence-based guideline for training

When someone is missing an arm, due to amputation of the upper-limb or a congenital deficiency, a prosthesis is often provided. Many prostheses remain unused in daily life as it is challenging for prosthesis users to learn to handle their prosthesis dexterously. Training can increase the use and functionality of upper-limb prostheses, but knowledge about efficient training is lacking. In this thesis I studied how people learn to use a prosthesis with the aim to provide guidance to the rehabilitation process. First, the movements of experienced prosthesis users were measured. Furthermore, factors determining the skill level of prosthesis users were identified. After determining how people use their prosthesis, the learning process during rehabilitation was examined. As there are only few prosthesis users, the latter studies were conducted with a prosthetic simulator. The simulator was specifically designed for non-amputated people, allowing more measurements to be performed and comparison of different types of training. Moreover, several activities such as reaching, grasping and fixating, and grip force control, were trained with the simulator during multiple training sessions to measure the changes in performance over time. Also the training structure was studied to determine the best way to present tasks. The results of the research are summarized in a training guideline for the rehabilitation of prosthesis users to achieve the highest possible skill level.