Personalizing treatment for severe limb injuries

Date:
January 10, 2022
Source:
University of Missouri-Columbia
Summary:
Scientists have developed an innovative technique using small
wearable sensors to gather data on how people -- who have suffered
from a traumatic hand amputation -- use a prothesis versus a
transplanted hand in everyday life. So far, the data shows people
with a transplanted hand demonstrate a more balanced use of their
hands than those who use a prothesis.



FULL STORY ==========================================================================
A team of scientists, led by Scott Frey at the University of Missouri,
have developed an innovative technique using small wearable sensors to
gather data on how people -- who have suffered from a traumatic hand
amputation -- use a prothesis versus a transplanted hand in everyday
life. So far, the data shows people with a transplanted hand demonstrate
a more balanced use of their hands than those who use a prothesis.


==========================================================================
Frey is the Miller Family Chair in Cognitive Neuroscience in the
Department of Psychological Sciences, and also has a joint appointment
in the Department of Physical Medicine and Rehabilitation.

"Most activities performed by a typical adult involve a fairly evenly
balanced reliance on both hands," Frey said. "Over the course of a normal
day, roughly 55% of people's activities involve the dominant hand and
45% involve the non- dominant hand. Now we have evidence that shows
experienced prosthesis users rely on their prosthetic hand during about
20% of daily activities and use their uninjured limb for the remaining
80%. Hand transplant recipients exhibit a more balanced pattern of limb
use that is closer to what we see in healthy adults, although not quite at
the 55%/45% split." Nevertheless, Frey also noted that a hand transplant
comes with significant risks, such as developing certain infections and
cancers from the lifetime use of immunosuppressants needed to help keep
the body from rejecting the new hand.

Frey said the findings from this study could help physicians and other
medical professionals personalize treatment options to meet a patient's individual needs based on their daily routine.

"We can bring people into a clinic or laboratory setting, and measure
how they are doing with a prosthetic or hand transplant, but these
observations are typically made under optimal and artificial conditions,
and therefore might not accurately show us how people are truly
functioning during their everyday lives," Frey said. "These sensors,
which continuously record movements over multiple days while people
go about their lives, have the ability to revolutionize treatments
by providing real world data that will help us develop personalized
approaches to treat traumatic hand loss." While military personnel can experience a traumatic hand loss in both combat and non-combat situations,
Frey said these injuries can also occur in civilian populations with work-related or recreational accidents, such as with farming equipment
or fireworks. The study collected data continuously over three days as participants went about their normal lives. They wore four different
sensors -- two on the wrists of the prosthetic or transplanted hand as
well as on the uninjured limb, and one on each the upper arms.

Frey said their technique could also lead to new ways for medical
professionals to evaluate the effectiveness of treatments and personalized
care for a variety of neurological diseases that affect hand use,
including multiple sclerosis and stroke. Frey's own mother had multiple sclerosis, and watching her condition deteriorate continues to motivate
his work into furthering knowledge of the neural mechanisms and cognitive processes that are responsible for complex behaviors.

In addition to possible applications in other areas of medicine,
including neurology, Frey's approach is currently being used to
investigate patterns of recovery in individuals with severe upper limb
injuries who are at increased risk of developing chronic one-handedness
through learned disuse of the injured limb. That project, scheduled to
be completed in fall 2024, is being supported by a $1.5 million grant
from the United States Department of Defense Restoring Warfighters with Neuromusculoskeletal Injuries Research Award, and includes collaborators
from the schools of medicine at Johns Hopkins University, Ohio State
University and Washington University in St. Louis.

Funding was provided by a grant from the Department of Defense
(MR140043). Co- authors include Binal Motawar, Kelli Buchanan, Carmen
Cirstea and Sean Morrow at MU; Christina Kaufman at University of
Louisville; and Phil Stevens at Hanger Clinic in Salt Lake City, Utah.

========================================================================== Story Source: Materials provided by University_of_Missouri-Columbia. Note: Content may be edited for style and length.


========================================================================== Journal Reference:
1. Scott Frey, Binal Motawar, Kelli Buchanan, Christina Kaufman, Phil
Stevens, Carmen Cirstea, Sean Morrow. Greater and More Natural
Use of the Upper Limbs During Everyday Life by Former Amputees
Versus Prosthesis Users. Neurorehabilitation and Neural Repair,
2022; 154596832110628 DOI: 10.1177/15459683211062889 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2022/01/220110145312.htm
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