Prosthetic Embodiment and Body Image Changes in Patients Undergoing Bionic Reconstruction Following Brachial Plexus Injury

Thumbnail Image
Journal Title
Journal ISSN
Volume Title
A1 Alkuperäisartikkeli tieteellisessä aikakauslehdessä
Degree programme
Frontiers in Neurorobotics, Volume 15
Brachial plexus injuries with multiple-root involvement lead to severe and long-lasting impairments in the functionality and appearance of the affected upper extremity. In cases, where biologic reconstruction of hand and arm function is not possible, bionic reconstruction may be considered as a viable clinical option. Bionic reconstruction, through a careful combination of surgical augmentation, amputation, and prosthetic substitution of the functionless hand, has been shown to achieve substantial improvements in function and quality of life. However, it is known that long-term distortions in the body image are present in patients with severe nerve injury as well as in prosthetic users regardless of the level of function. To date, the body image of patients who voluntarily opted for elective amputation and prosthetic reconstruction has not been investigated. Moreover, the degree of embodiment of the prosthesis in these patients is unknown. We have conducted a longitudinal study evaluating changes of body image using the patient-reported Body Image Questionnaire 20 (BIQ-20) and a structured questionnaire about prosthetic embodiment. Six patients have been included. At follow up 2.5–5 years after intervention, a majority of patients reported better BIQ-20 scores including a less negative body evaluation (5 out of 6 patients) and higher vital body dynamics (4 out of 6 patients). Moreover, patients described a strong to moderate prosthesis embodiment. Interestingly, whether patients reported performing bimanual tasks together with the prosthetic hand or not, did not influence their perception of the prosthesis as a body part. In general, this group of patients undergoing prosthetic substitution after brachial plexus injury shows noticeable inter-individual differences. This indicates that the replacement of human anatomy with technology is not a straight-forward process perceived in the same way by everyone opting for it.
Funding Information: The authors would like to thank Aron Cserveny for the preparation of the illustrations included in the manuscript. Furthermore, we thank Xaver Fuchs, Kristina Staudt, Herta Flor, and Martin Diers from Zentralinstitut f?r Seelische Gesundheit Mannheim (Germany) for their input regarding the formulation of the statements evaluating prosthetic embodiment. Funding. This project has received funding from the European Research Council (ERC) under the European Union's Horizon 2020 research and innovation program (grant agreement No 810346) and the Academy of Finland under project Hi-Fi BiNDIng (No 333149). Publisher Copyright: © Copyright © 2021 Sturma, Hruby, Boesendorfer, Pittermann, Salminger, Gstoettner, Politikou, Vujaklija, Farina and Aszmann. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
bionic reconstruction, body image, brachial plexus injury, embodiment/bodily experience, human-machine interfaces, prosthesis, upper limb amputation
Other note
Sturma , A , Hruby , L A , Boesendorfer , A , Pittermann , A , Salminger , S , Gstoettner , C , Politikou , O , Vujaklija , I , Farina , D & Aszmann , O C 2021 , ' Prosthetic Embodiment and Body Image Changes in Patients Undergoing Bionic Reconstruction Following Brachial Plexus Injury ' , Frontiers in Neurorobotics , vol. 15 , 645261 .