A scoping review of eye tracking metrics used to assess visuomotor behaviours of upper limb prosthesis users.
Kodi Y Cheng, Mayank Rehani, Jacqueline S Hebert
PMID 37095489WHAT IT FOUND
Upper limb prosthesis users consistently look at their prosthetic hand more and the target less than people with intact arms.
This visual dependency reflects a lack of sensory feedback. Gaze training and targeted reinnervation can reduce this reliance, improving efficiency.
Key findings
01Prosthesis users consistently fixate more on their prosthetic hand and less on the target compared to individuals with intact arm function.
02Gaze training, which encourages looking ahead at the target rather than monitoring the hand, improved performance speed and neural efficiency compared to traditional movement training.
03Targeted sensory reinnervation reduced fixations to the prosthetic hand and increased fixations to the next target, suggesting restored feedback can normalize visual behavior.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The review includes many studies using healthy participants with prosthetic simulators, which may not fully reflect the long-term adaptation and sensory experience of actual amputees. Sample sizes in the included studies were generally small, and many were case studies or pilot trials, limiting the strength of the conclusions. There is significant variability in the eye-tracking metrics and definitions used across the 17 studies, making direct comparison difficult. Most tasks were simple, seated, laboratory-based activities, which may not generalize to complex, real-world daily living tasks.
Declared interests
Funded by the Natural Sciences and Engineering Research Council of Canada. No specific commercial conflicts of interest were declared in the provided text.
The easy way to misread this
Do not assume that all forms of sensory feedback will automatically reduce visual monitoring. The review found that standard vibrotactile feedback did not change gaze behavior, whereas targeted reinnervation and specific gaze training did. The mechanism of feedback matters.