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

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.