Neurorehabilitation in upper limb amputation: understanding how neurophysiological changes can affect functional rehabilitation

Background: Significant advances have been made in developing new prosthetic technologies with the goal of restoring function to persons that suffer partial or complete loss of the upper limb. Despite these technological advances, many challenges remain in understanding barriers in patient adoption of technology, and what critical factors should be of focus in prosthetics development from a motor control perspective. This points to a potential opportunity to improve our understanding of amputation using neurophysiology and plasticity, and integrate this knowledge into the development of prosthetics technology in novel ways. Here, argument will be made to include a stronger focus on the neural and behavioral changes that result from amputation, and a better appreciation of the time-scale of changes which may significantly affect device adaptation, functional device utility, and motor learning implemented in rehabilitation environments. Conclusion: By strengthening our understanding of the neuroscience of amputation, we may improve the ability to couple neurorehabilitation with neuroengineering to support clinician needs in yielding improved outcomes in patients.