Competitive motivation increased home use and improved prosthesis self-perception after Cybathlon 2020 for neuromusculoskeletal prosthesis user.
Eric J Earley, Jan Zbinden, Maria Munoz-Novoa and 3 others
PMID 35578249WHAT IT FOUND
For one prosthesis user, Cybathlon training and competition were followed by more active home use and feeling more positive about the arm.
He said tasks like tying shoes became possible, but this is one case, not proof the event works for others.
Key findings
01Average daily use of the prosthetic hand increased from 4.59 min before Cybathlon to 6.52 min during Cybathlon training.
02After the competition, daily active use was 7.67 min, lower than during training but still 65.7% higher than before Cybathlon.
03The pilot said the Cybathlon drove him to use the prosthesis for tasks such as opening doors, cooking, washing dishes, and car maintenance, and that he now feels it is more part of his body.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
This is a single pilot, so the findings describe what happened to one person, not a pattern that can be expected in other prosthesis users. The analyses were planned after the data were collected, so they are exploratory rather than pre-specified tests of a primary outcome. The pilot received several changes at once: a powered wrist rotator, modified control settings, simultaneous hand-wrist control, a higher-capacity battery after the competition, training, and the competition itself. The study cannot separate which contributed to increased use or changed perception. The logger had no real-time clock, so day-to-day and time-of-day behaviour could not be analysed, and average phase differences could not be tested statistically. Active use only counted powered-on movement, missing passive use such as holding or carrying objects, and missing time when the prosthesis was worn but powered off. No pressure sensor was used, so object interaction could not be logged. Battery life dropped to 6 hours during training, which may have limited total daily use and confounds comparison with pre and post phases. The pilot's self-perception comes from retrospective interviews and phone follow-ups with one person, not from a blinded or independent outcome measure. The authors note his daily use may not represent other users of the same system; previous reports included up to 18 h per day, and similar studies reported 4-8 h per day.
Declared interests
The work was funded by Stiftelsen Promobilia, IngaBritt och Arne Lundbergs Forskningsstiftelse, Vetenskapsrådet, and Chalmers University of Technology. The supplied text does not give an author competing-interests declaration.
The easy way to misread this
Do not conclude that the Cybathlon competition alone caused more prosthesis use or a better feeling about the arm. This was one pilot, and during training he also received a new powered wrist, modified control settings, simultaneous hand and wrist control, extensive home practice, and later a higher-capacity battery, so the contribution of any single component cannot be separated.