Personalized treatment of serious limb injuries – sciencedaily


A team of scientists, led by Scott Frey of the University of Missouri, developed an innovative technique using small, wearable sensors to collect data on how people – who have suffered from traumatic hand amputation – use a prosthesis compared to a transplanted hand in everyday life. So far, data shows that people with a transplanted hand demonstrate a more balanced use of their hands than those who use a prosthesis.

Frey holds 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 of the activities a typical adult performs involve a fairly balanced reliance on both hands,” Frey said. “In a typical day, about 55% of people’s activities involve the dominant hand and 45% involve the non-dominant hand. We now have evidence that shows that experienced prosthetic users rely on their prosthetic hand for around 20% of daily activities. and use their uninjured limb for the remaining 80%. Hand transplant recipients exhibit a more balanced limb use pattern that is closer to what we see in healthy adults, although not quite at the 55% / 45% split. “

Nonetheless, Frey also noted that there are significant risks associated with a hand transplant, such as the development of certain infections and cancers due to lifelong use of immunosuppressants needed to prevent the body from rejecting the new hand.

Frey said the results of this study could help doctors and other healthcare professionals customize treatment options to meet a patient’s individual needs based on their daily routine.

“We can take people to a clinic or lab and measure how they are doing with a prosthesis or hand transplant, but these observations are usually made under optimal and artificial conditions, and therefore might not show us accurately. how people really function in their everyday lives, ”said Frey. “These sensors, which continuously record movement over days as people go about their business, have the ability to revolutionize treatment by providing real-world data that will help us develop personalized approaches to treat hand loss. traumatic.”

While military personnel can experience traumatic hand loss in combat and non-combat situations, Frey said these injuries can also occur in civilian populations with work-related or leisure-related accidents, such as with farm equipment or fireworks. The study collected data continuously for three days while participants continued with their normal lives. They wore four different sensors – two on the wrists of the prosthetic or transplanted hand as well as the uninjured limb, and one on each of the arms.

Frey said their technique could also lead to new ways for healthcare professionals to assess the effectiveness of personalized treatments and care for a variety of neurological conditions that affect hand use, including sclerosis. in plaques and strokes. Frey’s own mother suffered from multiple sclerosis, and her deteriorating condition continues to motivate her work to deepen knowledge of the neural mechanisms and cognitive processes responsible for complex behaviors.

In addition to possible applications in other areas of medicine, including neurology, Frey’s approach is currently being used to study recovery patterns in people with severe upper limb injuries who are at increased risk of developing chronic one-sidedness due to learned disuse of the injured limb. . This project, which is slated for completion in fall 2024, is supported by a $ 1.5 million grant from the United States Department of Defense for Combatant Restoration with Neuromusculoskeletal Injuries Research Award, and includes collaborators from medical schools at Johns Hopkins University, Ohio State University and the University of Washington in St. Louis.

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

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