gms | German Medical Science

Clinical issue/s: Losing an arm is a traumatic event that impacts the patient's life morphologically and psychologically. To restore neuromotor function or be able to control a myoelectric prosthesis, patients need to learn different muscle contraction patterns. Classic rehabilitation methods after nerve transfer or upper extremity amputation are based on repetitive exercises during which the patient's long-term motivation and effort is difficult to sustain.

Clinical reasoning: To make rehabilitation more motivating and effective, they receive EMG biofeedback in the form of a game-based mobile app. This type of playful rehabilitation intuitively trains the muscles needed for correct motor control.

Innovative, analytical or new approach: The training system, which the patients used at home for 5 weeks, consisted of an electrode bracelet to pick up the EMG signals and a tablet with the training app. The patients control the game with muscle contractions of varying duration and proportion, which must be performed according to the rhythm of the music game. The neuromuscular criteria evaluated were fine control, muscle endurance and separation of different muscle groups. The training goals were additionally tested with a sensory adapted Clothpin test, in which patients must successfully apply the above criteria in practice.

Contribution to advancing HT practice: The game-based system has been tested by able-bodied participants and patients with amputation or nerve transfers. Analysis shows that the probability of improving myoelectric control through the game is 90% and the usability and comprehensibility of the app was rated 95%. Patients were able to improve their motor control and all clinical parameters over the course of a 5 weeks training at home. The integration of modern technologies into the rehabilitation process had a positive effect on both patient motivation and neuromuscular performance during the intervention. Interactive elements of the game-based system should be individually adapted to the patient to achieve optimal results and maintain the high standard of treatment.