Bernstein’s Levels of Construction of Movements Applied to Upper Limb Prosthetics

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Abstract
This article addresses the neuromotor control processes underlying the use of an upper limb prosthesis. Knowledge of these processes is used to make recommendations as to how prostheses and prosthesis training should develop to advance the functionality of upper limb prostheses. Obviously, modern-day prostheses are not optimally integrated in neuromotor functioning. The current article frames the problems underlying the handling of upper limb prosthetic devices in the hierarchical levels of construction of movement as proposed by Bernstein (1996). It follows that 1) postural disturbances resulting from prosthetic use should be considered in training and in the development of prosthetic devices, 2) training should take into account that new synergies have to be learned, 3) the feedback about the state of the prosthesis should improve, and 4) the alteration between different grip patterns should be made easy and fast. We observed that many of the current innovations in the prosthetics field are in line with the aim to integrate the prosthesis in sensory-motor functioning.

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