Effects of kinematic vibrotactile feedback on learning to control a virtual prosthetic arm

BACKGROUND: After a limb is lost a prosthesis can restore function. For maximum utility, prosthetic limbs should accept movement commands and provide force and motion feedback, which can be conveyed with vibrotactile feedback (VIBF). While prior studies have shown that force-based VIBF benefits control, the merits of motion-based VIBF are unclear. Our goal was to clarify the effectiveness of position- and velocity-based VIBF for prosthetic arm control. METHODS: Healthy adults with normal limb function practiced a goal-directed task with a virtual myoelectric prosthetic arm. A linear resonant actuator on the wrist provided VIBF. Two groups with nine subjects each received amplitude modulated VIBF in addition to visual feedback while practicing the task. In one group, the VIBF was proportional to the virtual arm’s position, and in the other group, velocity. A control group of nine subjects received only visual feedback. Subjects practiced for 240 trials, followed by 180 trials with feedback manipulations for the VIBF groups. Performance was characterized by end-point error, movement time, and a composite skill measure that combined these quantities. A second experiment with a new group of five subjects assessed discrimination capabilities between different position- and velocity-based VIBF profiles. RESULTS: With practice all groups improved their skill in controlling the virtual prosthetic arm. Subjects who received additional position- and velocity-based VIBF learned at the same rate as the control group, who received only visual feedback (learning rate time constant: about 40 trials). When visual feedback was subsequently removed leaving only VIBF, performance was no better than with no feedback at all. When VIBF was removed leaving only visual feedback, about half of the participants performed better, instead of worse. The VIBF discrimination tests showed that subjects could detect virtual arm angular position and velocity differences of about 5 deg and 20 deg/s, respectively. CONCLUSIONS: Kinematic VIBF did not increase the rate of skill acquisition or improve performance when controlling a virtual myoelectric prosthetic arm, whether provided in isolation or coupled with visual feedback. VIBF had a deleterious effect on performance for some individuals, who may have had difficulty integrating kinematic VIBF information into their control strategies.