A Focus of Attention-Based Virtual Training Platform for Pre-Prosthetic Myoelectric Skill Acquisition: A Proof-of-Concept Study

2026-05-29

AI Summary

This study addresses a critical gap in myoelectric prosthetic training, which has predominantly emphasized internal muscle activation while neglecting externally oriented, functionally relevant practice. For the first time, the theory of focus of attention (FoA) is integrated into virtual pre-prosthetic training through a novel platform that combines EMG-driven cursor control with real-time animated hand gesture feedback. The system implements both internal and external FoA protocols, delivering concurrent muscular and functional feedback. Results demonstrate that both attentional foci support skill acquisition and short-term retention; however, external focus significantly enhances long-term retention, underscoring its pivotal role in bridging simulated training and real-world functional use of prosthetic devices.

Abstract

Advances in myoelectric prosthetic technology have substantially increased the functional potential of modern devices. Accordingly, heightened control demands have led to the acknowledgement of pre-prosthetic training as a key stage in the acquisition of myoelectric skills. Existing training paradigms largely emphasize internal muscle activation while external, goal-directed outcomes required for effective real-world use are often neglected. We address this gap by introducing a virtual pre-prosthetic training platform that integrates EMG-driven cursor with animated hand gestures, enabling the delivery of both muscle-level and functional-level feedback. In this proof-of-concept study, participants were assigned to one of two focus of attention (FoA) protocols, each incorporating both feedback types but differing in whether internal or external FoA was emphasised. Participants successfully acquired and retained myoelectric skill across both protocols, but distinct performance characteristics and learning strategies emerged, indicating that both FoAs contribute meaningfully to learning and that their timing may play an important role. External FoA was positively associated with retention, suggesting that it may strengthen the link between training and skill acquisition. Together, the results demonstrate the feasibility of an FoA-based virtual training platform for pre-prosthetic applications and indicate that it can provide a foundation for designing training protocols that better prepare users for prosthetic use.

Problem

• pre-prosthetic training
• myoelectric skill acquisition
• focus of attention
• functional feedback
• EMG-based control

Innovation

• Focus of Attention
• myoelectric training
• virtual platform
• dual feedback
• pre-prosthetic rehabilitation