Understanding and Measuring the Cognitive Load of Amputees for Rehabilitation and Prosthesis Development.
Robin Rackerby, Stephan Lukosch, Deborah Munro
PMID 36123983WHAT IT FOUND
Amputees experience extra mental strain from emotional fatigue and neural fatigue, not just physical effort.
There is no standard clinical test to measure this load yet. Functional near-infrared spectroscopy shows promise for measuring it during actual prosthesis use.
Key findings
01Cognitive load in amputees is driven by two specific factors: emotional fatigue (frustration with device control) and neural fatigue (brain changes from lost sensation).
02Standard cognitive tests like the Montreal Cognitive Assessment are not appropriate for amputees because they cannot detect slight variations in load from everyday prosthesis use.
03Functional near-infrared spectroscopy (fNIRS) is the most promising measurement technique because it is portable and can measure cognitive load directly while the patient moves with a prosthesis.
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
This is a narrative review, not a systematic review, so the selection of articles was based on relevance and author choice rather than a strict protocol. The review found no studies that directly quantified cognitive load in amputees using their own prostheses; most data comes from intact-limb simulations or theoretical models. There is no standardized clinical test available today, so these findings are currently theoretical for day-to-day practice.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not assume these measurement techniques are ready for clinical use. The review explicitly states that no standardized tests exist for clinicians to measure cognitive load in amputees, and fNIRS is currently a research tool, not a clinical assessment.