Coactivation index of children with congenital upper limb reduction deficiencies before and after using a wrist-driven 3D printed partial hand prosthesis

Jorge M Zuniga, Katsavelis Dimitrios, Jean L. Peck, Rakesh Srivastava, James E. Pierce, Drew R. Dudley, David A. Salazar, Keaton J. Young, Brian Knarr

Research output: Contribution to journalArticle

Abstract

Background: Co-contraction is the simultaneous activation of agonist and antagonist muscles that produces forces around a joint. It is unknown if the use of a wrist-driven 3D printed transitional prostheses has any influence on the neuromuscular motor control strategies of the affected hand of children with unilateral upper-limb reduction deficiencies. Thus, the purpose of the current investigation was to examine the coactivation index (CI) of children with congenital upper-limb reduction deficiencies before and after 6 months of using a wrist-driven 3D printed partial hand prosthesis. Methods: Electromyographic activity of wrist flexors and extensors (flexor carpi ulnaris and extensor digitorum) was recorded during maximal voluntary contraction of the affected and non-affected wrists. Co-contraction was calculated using the coactivation index and was expressed as percent activation of antagonist over agonist. Nine children (two girls and seven boys, 6 to 16 years of age) with congenital upper-limb deficiencies participated in this study and were fitted with a wrist-driven 3D printed prosthetic hand. From the nine children, five (two girls and three boys, 7 to 10 years of age) completed a second visit after using the wrist-driven 3D printed partial hand prosthesis for 6 months. Results: Separate two-way repeated measures ANOVAs were performed to analyze the coactivation index and strength data. There was a significant main effect for hand with the affected hand resulting in a higher coactivation index for flexion and extension than the non-affected hand. For wrist flexion there was a significant main effect for time indicating that the affected and non-affected hand had a significantly lower coactivation index after a period of 6 months. Conclusion: The use of a wrist-driven 3D printed hand prosthesis lowered the coactivation index by 70% in children with congenital upper limb reduction deficiencies. This reduction in coactivation and possible improvement in motor control strategies can potentially improve prosthetic rehabilitation outcomes.

Original languageEnglish (US)
Article number48
JournalJournal of NeuroEngineering and Rehabilitation
Volume15
Issue number1
DOIs
StatePublished - Jun 8 2018

Fingerprint

Wrist
Upper Extremity
Prostheses and Implants
Hand
Analysis of Variance
Joints
Muscles

Keywords

  • Additive manufacturing
  • Arm
  • Biomechanics
  • Computer-aided design
  • Custom-made prostheses
  • Hand
  • Motor control
  • Pediatric
  • Reaching

ASJC Scopus subject areas

  • Rehabilitation
  • Health Informatics

Cite this

Coactivation index of children with congenital upper limb reduction deficiencies before and after using a wrist-driven 3D printed partial hand prosthesis. / Zuniga, Jorge M; Dimitrios, Katsavelis; Peck, Jean L.; Srivastava, Rakesh; Pierce, James E.; Dudley, Drew R.; Salazar, David A.; Young, Keaton J.; Knarr, Brian.

In: Journal of NeuroEngineering and Rehabilitation, Vol. 15, No. 1, 48, 08.06.2018.

Research output: Contribution to journalArticle

Zuniga, Jorge M ; Dimitrios, Katsavelis ; Peck, Jean L. ; Srivastava, Rakesh ; Pierce, James E. ; Dudley, Drew R. ; Salazar, David A. ; Young, Keaton J. ; Knarr, Brian. / Coactivation index of children with congenital upper limb reduction deficiencies before and after using a wrist-driven 3D printed partial hand prosthesis. In: Journal of NeuroEngineering and Rehabilitation. 2018 ; Vol. 15, No. 1.
@article{a83feddb3d0c496b9243498a7b75d8bf,
title = "Coactivation index of children with congenital upper limb reduction deficiencies before and after using a wrist-driven 3D printed partial hand prosthesis",
abstract = "Background: Co-contraction is the simultaneous activation of agonist and antagonist muscles that produces forces around a joint. It is unknown if the use of a wrist-driven 3D printed transitional prostheses has any influence on the neuromuscular motor control strategies of the affected hand of children with unilateral upper-limb reduction deficiencies. Thus, the purpose of the current investigation was to examine the coactivation index (CI) of children with congenital upper-limb reduction deficiencies before and after 6 months of using a wrist-driven 3D printed partial hand prosthesis. Methods: Electromyographic activity of wrist flexors and extensors (flexor carpi ulnaris and extensor digitorum) was recorded during maximal voluntary contraction of the affected and non-affected wrists. Co-contraction was calculated using the coactivation index and was expressed as percent activation of antagonist over agonist. Nine children (two girls and seven boys, 6 to 16 years of age) with congenital upper-limb deficiencies participated in this study and were fitted with a wrist-driven 3D printed prosthetic hand. From the nine children, five (two girls and three boys, 7 to 10 years of age) completed a second visit after using the wrist-driven 3D printed partial hand prosthesis for 6 months. Results: Separate two-way repeated measures ANOVAs were performed to analyze the coactivation index and strength data. There was a significant main effect for hand with the affected hand resulting in a higher coactivation index for flexion and extension than the non-affected hand. For wrist flexion there was a significant main effect for time indicating that the affected and non-affected hand had a significantly lower coactivation index after a period of 6 months. Conclusion: The use of a wrist-driven 3D printed hand prosthesis lowered the coactivation index by 70{\%} in children with congenital upper limb reduction deficiencies. This reduction in coactivation and possible improvement in motor control strategies can potentially improve prosthetic rehabilitation outcomes.",
keywords = "Additive manufacturing, Arm, Biomechanics, Computer-aided design, Custom-made prostheses, Hand, Motor control, Pediatric, Reaching",
author = "Zuniga, {Jorge M} and Katsavelis Dimitrios and Peck, {Jean L.} and Rakesh Srivastava and Pierce, {James E.} and Dudley, {Drew R.} and Salazar, {David A.} and Young, {Keaton J.} and Brian Knarr",
year = "2018",
month = "6",
day = "8",
doi = "10.1186/s12984-018-0392-9",
language = "English (US)",
volume = "15",
journal = "Journal of NeuroEngineering and Rehabilitation",
issn = "1743-0003",
publisher = "BioMed Central",
number = "1",

}

TY - JOUR

T1 - Coactivation index of children with congenital upper limb reduction deficiencies before and after using a wrist-driven 3D printed partial hand prosthesis

AU - Zuniga, Jorge M

AU - Dimitrios, Katsavelis

AU - Peck, Jean L.

AU - Srivastava, Rakesh

AU - Pierce, James E.

AU - Dudley, Drew R.

AU - Salazar, David A.

AU - Young, Keaton J.

AU - Knarr, Brian

PY - 2018/6/8

Y1 - 2018/6/8

N2 - Background: Co-contraction is the simultaneous activation of agonist and antagonist muscles that produces forces around a joint. It is unknown if the use of a wrist-driven 3D printed transitional prostheses has any influence on the neuromuscular motor control strategies of the affected hand of children with unilateral upper-limb reduction deficiencies. Thus, the purpose of the current investigation was to examine the coactivation index (CI) of children with congenital upper-limb reduction deficiencies before and after 6 months of using a wrist-driven 3D printed partial hand prosthesis. Methods: Electromyographic activity of wrist flexors and extensors (flexor carpi ulnaris and extensor digitorum) was recorded during maximal voluntary contraction of the affected and non-affected wrists. Co-contraction was calculated using the coactivation index and was expressed as percent activation of antagonist over agonist. Nine children (two girls and seven boys, 6 to 16 years of age) with congenital upper-limb deficiencies participated in this study and were fitted with a wrist-driven 3D printed prosthetic hand. From the nine children, five (two girls and three boys, 7 to 10 years of age) completed a second visit after using the wrist-driven 3D printed partial hand prosthesis for 6 months. Results: Separate two-way repeated measures ANOVAs were performed to analyze the coactivation index and strength data. There was a significant main effect for hand with the affected hand resulting in a higher coactivation index for flexion and extension than the non-affected hand. For wrist flexion there was a significant main effect for time indicating that the affected and non-affected hand had a significantly lower coactivation index after a period of 6 months. Conclusion: The use of a wrist-driven 3D printed hand prosthesis lowered the coactivation index by 70% in children with congenital upper limb reduction deficiencies. This reduction in coactivation and possible improvement in motor control strategies can potentially improve prosthetic rehabilitation outcomes.

AB - Background: Co-contraction is the simultaneous activation of agonist and antagonist muscles that produces forces around a joint. It is unknown if the use of a wrist-driven 3D printed transitional prostheses has any influence on the neuromuscular motor control strategies of the affected hand of children with unilateral upper-limb reduction deficiencies. Thus, the purpose of the current investigation was to examine the coactivation index (CI) of children with congenital upper-limb reduction deficiencies before and after 6 months of using a wrist-driven 3D printed partial hand prosthesis. Methods: Electromyographic activity of wrist flexors and extensors (flexor carpi ulnaris and extensor digitorum) was recorded during maximal voluntary contraction of the affected and non-affected wrists. Co-contraction was calculated using the coactivation index and was expressed as percent activation of antagonist over agonist. Nine children (two girls and seven boys, 6 to 16 years of age) with congenital upper-limb deficiencies participated in this study and were fitted with a wrist-driven 3D printed prosthetic hand. From the nine children, five (two girls and three boys, 7 to 10 years of age) completed a second visit after using the wrist-driven 3D printed partial hand prosthesis for 6 months. Results: Separate two-way repeated measures ANOVAs were performed to analyze the coactivation index and strength data. There was a significant main effect for hand with the affected hand resulting in a higher coactivation index for flexion and extension than the non-affected hand. For wrist flexion there was a significant main effect for time indicating that the affected and non-affected hand had a significantly lower coactivation index after a period of 6 months. Conclusion: The use of a wrist-driven 3D printed hand prosthesis lowered the coactivation index by 70% in children with congenital upper limb reduction deficiencies. This reduction in coactivation and possible improvement in motor control strategies can potentially improve prosthetic rehabilitation outcomes.

KW - Additive manufacturing

KW - Arm

KW - Biomechanics

KW - Computer-aided design

KW - Custom-made prostheses

KW - Hand

KW - Motor control

KW - Pediatric

KW - Reaching

UR - http://www.scopus.com/inward/record.url?scp=85048169336&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85048169336&partnerID=8YFLogxK

U2 - 10.1186/s12984-018-0392-9

DO - 10.1186/s12984-018-0392-9

M3 - Article

VL - 15

JO - Journal of NeuroEngineering and Rehabilitation

JF - Journal of NeuroEngineering and Rehabilitation

SN - 1743-0003

IS - 1

M1 - 48

ER -