Grasp Posture Variability Leads to Greater Ipsilateral Sensorimotor Beta Activation During Simulated Prosthesis Use.

Motor behaviour using upper-extremity prostheses of different levels is greatly variable, leading to challenges interpreting ideal rehabilitation strategies. Elucidating the underlying neural control mechanisms driving variability benefits our understanding of adaptation after limb loss. In this follow-up study, non-amputated participants completed simple and complex reach-to-grasp motor tasks using a body-powered transradial or partial-hand prosthesis simulator. We hypothesised that under complex task constraints, individuals employing variable grasp postures will show greater sensorimotor beta activation compared to individuals relying on uniform grasping, and activation will occur later in variable compared to uniform graspers. In the simple task, partial-hand variable and transradial users showed increased neural activation from the early to late phase of the reach, predominantly in the hemisphere ipsilateral to device use. In the complex task, only partial-hand variable graspers showed a significant increase in neural activation of the sensorimotor cortex from the early to the late phase of the reach. These results suggest that grasp variability may be a crucial component in the mechanism of neural adaptation to prosthesis use, and may be mediated by device level and task complexity, with implications for rehabilitation after amputation.