Systematic Changes In Body Image Following Formation Of Phantom Limbs

This book presents new findings on body image and also introduces new neuroscience-based methods for the fields of neurology and neurorehabilitation. Even when the hand is stationary we know its position – information that is needed by the brain to plan movements. If the sensory input from a limb is removed as the result of an accident, or as part of an experiment with local anesthesia, then a ‘phantom’ limb commonly develops. We used ischemic anesthesia of one limb to study the mechanisms that define this phenomenon. Surprisingly, if the fingers, wrist, elbow, ankle, and knee are extended before and during an ischemic block, then the perceived limb is flexed at the joint and vice versa. Furthermore, the limb is perceived to move continuously with no default position. The key parameter for these illusory changes in limb position is the difference in discharge rates between afferents in the flexor and extensor muscles at a joint. The final position of the phantom limb depends on its initial position, suggesting that a body image uses incoming proprioceptive information for determination of starting points and endpoints when generating movements. In addition, the change in position does not involve limb postures that are anatomically impossible, suggesting that illusory posture is constrained by body maps. These results provide new information about how the brain generates phantom limbs.

This book explores the fascinating area of interpersonal coordination in force production tasks, outlining the author’s extensive research to date and presenting stimulating new perspectives. The purpose is to provide a detailed exposition of current understanding of the science behind interpersonal joint action. Readers will find clear explanation of concepts from social cognition and neuroscience that are key to an understanding of the field, including the social brain hypothesis, the mirror neuron system, and joint action, as well as other relevant background information. The author then proceeds to present an overview of recent original studies on interpersonal movement coordination performed at his laboratory in Japan. These studies provide insights into such issues as complementary and synchronous force production in joint action, bidirectional transfer between joint and solo actions, and motor control hierarchy in joint action involving bimanual force. They also set the direction for integration of knowledge of physical properties and social cognition. The book will be of interest for researchers and graduate students in all areas of the biomedical sciences.

Each year in the United States, an estimated 40,000 persons lose a limb. Of these amputees, approximately 30% lose a hand or an arm. This loss is most frequently related to trauma occurring in the healthy young adult male and is often work related. Approximately 3% of all amputees are born with congenital limb absence. In children, the ratio of congenital to acquired amputation is 2: 1, and the ratio of upper-limb to lower-limb amputees is 1. 2: 1. Therefore, since relatively few amputations result in upper-limb loss, only a small number of health practitioners, even those specializing in amputee rehabilitation, have the opportunity to provide services for a significant number of arm amputees. As a result, clinicians need to share their experiences so that the full range of options for optimum care and rehabilitation of the patient population may be considered. To meet this challenge for wider communication of clinical experience, a group of upper-limb amputee specialists met in Houston, Texas, in 1981 to serve as the core faculty for a course entitled "Contemporary Issues in Upper Extremity Amputation and Prosthetic Function. " This program provided the opportunity for surgeons, physiatrists, engineers, prosthetists, social workers, psychologists, occupational therapists, and physical therapists from the United States and Canada to discuss their extensive experience in working with upper extremity amputees. A second conference continuing the discussion of upper limb amputee rehabilitation was held one year later.

Implement TMR with Your Patients and Improve Their Quality of Life Developed by Dr. Todd A. Kuiken and Dr. Gregory A. Dumanian, targeted muscle reinnervation (TMR) is a new approach to accessing motor control signals from peripheral nerves after amputation and providing sensory feedback to prosthesis users. This practical approach has many advantages over other neural-machine interfaces for the improved control of artificial limbs. Targeted Muscle Reinnervation: A Neural Interface for Artificial Limbs provides a template for the clinical implementation of TMR and a resource for further research in this new area of science. After describing the basic scientific concepts and key principles underlying TMR, the book presents surgical approaches to transhumeral and shoulder disarticulation amputations. It explores the possible role of TMR in the prevention and treatment of end-neuromas and details the principles of rehabilitation, prosthetic fitting, and occupational therapy for TMR patients. The book also describes transfer sensation and discusses the surgical and functional outcomes of the first several TMR patients. It concludes with emerging research on using TMR to further improve the function and quality of life for people with limb loss. With contributions from renowned leaders in the field, including Drs. Kuiken and Dumanian, this book is a useful guide to implementing TMR in patients with high-level upper limb amputations. It also supplies the foundation to enable improvements in TMR techniques and advances in prosthetic technology.

The Oxford Textbook of Vascular Surgery draws on the expertise of over 130 specialist contributors to encompass the field of vascular surgery. Through the use of figures, findings of contemporary trials, and additional online content, this textbook is an excellent study material for surgical trainees entering their final two years of training, in addition to serving as an effective reference source for practicing surgeons. This volume discusses the epidemiology, vascular biology, clinical features and management of diseases that affect the vasculature and contains dedicated chapters which address topics such as paediatric surgery, damage control surgery, and amputations. The text follows a logical framework which complements the published Intercollegiate Surgery Curriculum making it particularly useful in preparation for the Intercollegiate Examination. The online version of The Oxford Textbook of Vascular Surgery is free for twelve months to individual purchasers of this book and contains the full text of the print edition, links to external sources and informative videos demonstrating current surgical techniques, making this a valuable resource for practicing surgeons. The field of vascular surgery has advanced rapidly in recent years and has expanded to include the techniques of interventional radiology and cardiology which are also extensively covered in this volume, making it an authoritative modern text. By combining contemporary evidence-based knowledge with informative figures, online resources and links to the current training curriculum, The Oxford Textbook of Vascular Surgery is a highly valuable source of information and will become the standard reference text for all who study vascular disease and its treatment.

Using a series of case studies, 'Phantoms in the brain' introduces a strange and unexplored mental world. Ramachandran, through his research into brain damage, has discovered that the brain can react in strange ways to major physical changes.

Graded Motor Imagery is a complex series of treatments including graded left/right judgement exercises, imagined movements and use of mirrors targeting neuropathic pain problems.