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RecruitingNCT07666204REINVENTUpdated Jun 24, 2026

Using Sensorimotor Reorganization Following Upper Limb Amputation to Improve Prosthetic Control

An interventional study of Caracterisation and Mapping in Amputation of Upper Limb and Agenesis of Upper Limb, sponsored by Union de Gestion des Etablissements des Caisses d'Assurance Maladie - Nord Est. Recruiting at 2 sites in France. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-06-24.

Sponsored by Union de Gestion des Etablissements des Caisses d'Assurance Maladie - Nord Est · Not applicable, Interventional, and Basic science

From the registry’s dates

  • Started Apr 2026; still recruiting 5 months later.
Phase
Not applicable
Study type
Interventional
Enrollment
50
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

Amputation of an upper limb results in a disruption of the sensorimotor loop and a reorganization of the nervous system, leading to the emergence of a phantom limb and the adaptation of compensatory motor strategies. This project aims to leverage these phenomena (induced sensations, phantom mobility, and compensations) to improve control, sensory feedback, and the appropriation of prostheses, in order to reduce cognitive load and musculoskeletal disorders.

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Conditions studied

  • Amputation of Upper Limb
  • Agenesis of Upper Limb

Keywords

  • amputation
  • amputation of upper limb
  • prosthesis
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In context

Lead sponsor

Union de Gestion des Etablissements des Caisses d'Assurance Maladie - Nord Est is the lead sponsor of 14 studies on the registry; 7 are open to participants now.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • people aged 18 or more
  • amputation or agenesis of one uper limb, above the wrist or higher
  • understanding of the French language and the ability to express onself in that language (for semi-structured interviews)
  • affiliation to a social security programm

Exclusion criteria

Exclusion Criteria:

  • history of progressive psychiatric or neurological disorders or disorders with residual effects
  • pregnant or breastfeeding woman
  • minor
  • an adult under legal guardianship
  • pain influencing movement (trunk, residual limb, phantom limb, contralateral limb)
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Study design

Phase
Not applicable
Primary purpose
Basic science
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
50 participants (estimated)

Study arms

  • Experimental
    Phantom-limb and motor compensation evaluation

    Other: Caracterisation · Other: Mapping · Other: Phantom sensations · Other: Classification · Other: Prosthetic control · Other: motor compensations · Other: Use of motor reorganization and compensation

Interventions

  • OtherCaracterisation

    The objective of this phase is to identify, from a population of individuals with upper limb amputations, a sufficient number of participants who experience non-painful phenomena related to their phantom limb (sensations, mobility, etc.) prior to the subsequent phases. This phase takes the form of a semi-structured individual interview conducted by one of the study investigators.

  • OtherMapping

    The objective of this phase is to study the phenomenon of induced phantom sensations in individuals who reported experiencing such sensations during the previous phase. This phase involves a systematic exploration of the areas of the residual limb whose stimulation induces non-painful phantom sensations, as well as the type of sensations thus induced.

  • OtherPhantom sensations

    The goal of this phase is to determine whether stimulation of the residual limb that induces sensations in the phantom limb can help people with lower-limb amputations use their prostheses more effectively.

  • OtherClassification

    The objective of this phase is to characterize the influence of voluntary movements of the residual limb on the myoelectric activity associated with phantom limb mobility. Myoelectric activity and cognitive load will be assessed

  • OtherProsthetic control

    The objective of this phase is to evaluate the performance of a prosthetic control method based on phantom limb movement in individuals with upper limb amputations. The principle behind this method is to control the movements of the prosthesis using the corresponding movements of the phantom limb, by utilizing the myoelectric activity that can be measured on the residual limb during voluntary phantom limb movements.

  • Othermotor compensations

    The objective of this phase is to characterize and quantify the compensatory movements associated with the use of a conventional myoelectric upper limb prosthesis. The participant will perform the manipulation tasks defined in the SHAP method, as well as the clothespin displacement test.

  • OtherUse of motor reorganization and compensation

    The objective of this phase is to evaluate the performance of a prosthesis control method based on the compensatory movements associated with the use of an upper limb prosthesis. During this phase, participants will not use their personal prostheses but rather an experimental prosthesis developed by the investigators specifically for this study. The experimental prosthesis will be programmed to implement the control method based on compensatory movements, which is the focus of this evaluation.

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What researchers measure

Primary outcomes

  1. Characterization of phantom limb

    Semi-structured interview to elicit patients' descriptions of phantom sensations

    Time frame: Baseline (Phase 1 session) ; optional repeat assessment at 6 months

Secondary outcomes

  1. NASA TLX Score

    The cognitive load associated with the various tasks will be assessed. The higher the score, the greater the cognitive load.

    Time frame: Administered at the end of each experimental sequence, up to 6 months

  2. Southampton Hand Assessment Procedure (SHAP)

    A standardized, timed questionnaire-led assessment of pathological hand function. It evaluates overall hand function and dexterity through 26 tasks, including 12 abstract object manipulations and 14 activities of daily living (ADL). Tasks are timed to calculate an overall Index of Function (IoF) scored out of 100, where higher scores reflect better hand function.

    Time frame: At each evaluation session, up to 6 month

  3. Clothespin Relocation Test (CRT)

    A functional upper limb assessment measuring manual dexterity and proximal control. Participants are timed while transferring a set number of clothespins from a horizontal bar to a vertical bar (and/or vice versa) against varying spring resistances. Performance is measured by the total time taken (in seconds) to complete the task, where a shorter duration indicates better motor efficiency and coordination

    Time frame: At each evaluation session, up to 6 months

Other outcomes

  1. Mapping of induced sensations

    Mapping the relationships between real members and ghost members

    Time frame: Baseline (Phase 2 session) and after the home-training period (up to 6 months)

  2. Assessment of the effects of phantom sensation induction

    Whenever the participant controls the virtual hand, its movements (i.e., degree of opening and closing) will be recorded. The participant's performance will be measured by the rate of correctly identifying the stiffer object for each pair of objects presented.

    Time frame: Day 1 (single Phase 3 session)

  3. Classification of myoelectric activity associated with phantom limb movements

    Classification of recorded myoelectric activity for residual and intact limbs

    Time frame: Day 1 (single Phase 4 session)

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Study locations

2 of 2 sites recruiting
  • Institut Régional de Médecine Physique et de Réadaptation, Filière Locomoteur
    Nancy, 54000, France
    • Amélie Touillet, Doctor PMR · Principal investigator
    • Jonathan Pierret, Head of the Unit · Sub investigator
    • Isabelle Loiret, Doctor PMR · Sub investigator
    • Pierrick Herbé, Doctor PMR · Sub investigator
    • Jean Paysant, MD, PhD PMR · Sub investigator
    Recruiting
  • Fondation Saint-Hélier
    Rennes, 35000, France
    • Emilie Leblong, Doctor PMR · Principal investigator
    • Thomas Lambert, Doctor PMR · Sub investigator
    • Marie Chantrelle-Boucherit, Doctor PMR · Sub investigator
    Recruiting
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References and documents

Publications

  • Hussaini A, Hill W, Kyberd P. Clinical evaluation of the refined clothespin relocation test: A pilot study. Prosthet Orthot Int. 2019 Oct;43(5):485-491. doi: 10.1177/0309364619843779. Epub 2019 Jul 2. PubMed 31264508 ↗
  • Kuorinka I, Jonsson B, Kilbom A, Vinterberg H, Biering-Sorensen F, Andersson G, Jorgensen K. Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Appl Ergon. 1987 Sep;18(3):233-7. doi: 10.1016/0003-6870(87)90010-x. PubMed 15676628 ↗
  • Chateaux M, Rossel O, Verite F, Nicol C, Touillet A, Paysant J, Jarrasse N, De Graaf JB. New insights into muscle activity associated with phantom hand movements in transhumeral amputees. Front Hum Neurosci. 2024 Aug 30;18:1443833. doi: 10.3389/fnhum.2024.1443833. eCollection 2024. PubMed 39281369 ↗
  • Rossel O, Chateaux M, Jarrassé N, Vérité F, Touillet A, Nicol C, Paysant J, and De Graaf JB (2023). Phantom movement training without classifier performance feedback improves mobilization ability while maintaining EMG pattern classification. IEEE Transitions on Medical Robotics and Bionics 5(1): 133-142.
  • Wu CW, Kaas JH. Spinal cord atrophy and reorganization of motoneuron connections following long-standing limb loss in primates. Neuron. 2000 Dec;28(3):967-78. doi: 10.1016/s0896-6273(00)00167-7. PubMed 11163280 ↗
  • Wu CW, Kaas JH. The effects of long-standing limb loss on anatomical reorganization of the somatosensory afferents in the brainstem and spinal cord. Somatosens Mot Res. 2002;19(2):153-63. doi: 10.1080/08990220220133261. PubMed 12088390 ↗
  • Qi HX, Stewart Phillips W, Kaas JH. Connections of neurons in the lumbar ventral horn of spinal cord are altered after long-standing limb loss in a macaque monkey. Somatosens Mot Res. 2004 Sep-Dec;21(3-4):229-39. doi: 10.1080/08990220400012588. PubMed 15763908 ↗
  • Bekrater-Bodmann R, Foell J, Diers M, Kamping S, Rance M, Kirsch P, Trojan J, Fuchs X, Bach F, Cakmak HK, Maass H, Flor H. The importance of synchrony and temporal order of visual and tactile input for illusory limb ownership experiences - an FMRI study applying virtual reality. PLoS One. 2014 Jan 31;9(1):e87013. doi: 10.1371/journal.pone.0087013. eCollection 2014. PubMed 24498012 ↗
  • Reilly KT, Mercier C, Schieber MH, Sirigu A. Persistent hand motor commands in the amputees' brain. Brain. 2006 Aug;129(Pt 8):2211-23. doi: 10.1093/brain/awl154. Epub 2006 Jun 24. PubMed 16799174 ↗
  • Karl A, Birbaumer N, Lutzenberger W, Cohen LG, Flor H. Reorganization of motor and somatosensory cortex in upper extremity amputees with phantom limb pain. J Neurosci. 2001 May 15;21(10):3609-18. doi: 10.1523/JNEUROSCI.21-10-03609.2001. PubMed 11331390 ↗
  • Touillet A, Peultier-Celli L, Nicol C, Jarrasse N, Loiret I, Martinet N, Paysant J, De Graaf JB. Characteristics of phantom upper limb mobility encourage phantom-mobility-based prosthesis control. Sci Rep. 2018 Oct 18;8(1):15459. doi: 10.1038/s41598-018-33643-0. PubMed 30337602 ↗
  • Jarrasse N, de Montalivet E, Richer F, Nicol C, Touillet A, Martinet N, Paysant J, de Graaf JB. Phantom-Mobility-Based Prosthesis Control in Transhumeral Amputees Without Surgical Reinnervation: A Preliminary Study. Front Bioeng Biotechnol. 2018 Nov 29;6:164. doi: 10.3389/fbioe.2018.00164. eCollection 2018. PubMed 30555823 ↗
  • Bachini L, Mahe C, Touillet A, Loiret I, Mesure S, Bonillo I, Paysant J, De Graaf JB. The missing link: How is the phantom limb influenced by prosthesis wearing in people with lower-limb amputation? Prosthet Orthot Int. 2025 Dec 1;49(6):624-629. doi: 10.1097/PXR.0000000000000377. Epub 2024 Oct 9. PubMed 39724648 ↗
  • Bachini L, Liszez S, Mesure S, Mahe C, Touillet A, Loiret I, Paysant J, De Graaf JB. Phantom Sensations Influenced by Global and Local Modifications of the Prosthetic Socket as a Potential Solution for Natural Somatosensory Feedback During Walking: A Preliminary Study of a Single Case. Front Rehabil Sci. 2022 Feb 23;3:803912. doi: 10.3389/fresc.2022.803912. eCollection 2022. PubMed 36188906 ↗
  • De Graaf JB, Jarrasse N, Nicol C, Touillet A, Coyle T, Maynard L, Martinet N, Paysant J. Phantom hand and wrist movements in upper limb amputees are slow but naturally controlled movements. Neuroscience. 2016 Jan 15;312:48-57. doi: 10.1016/j.neuroscience.2015.11.007. Epub 2015 Nov 10. PubMed 26556065 ↗
  • Legrand M, Marchand C, Richer F, Touillet A, Martinet N, Paysant J, Morel G, Jarrasse N. Simultaneous Control of 2DOF Upper-Limb Prosthesis With Body Compensations-Based Control: A Multiple Cases Study. IEEE Trans Neural Syst Rehabil Eng. 2022;30:1745-1754. doi: 10.1109/TNSRE.2022.3186266. Epub 2022 Jul 4. PubMed 35749322 ↗
  • Metzger AJ, Dromerick AW, Holley RJ, Lum PS. Characterization of compensatory trunk movements during prosthetic upper limb reaching tasks. Arch Phys Med Rehabil. 2012 Nov;93(11):2029-34. doi: 10.1016/j.apmr.2012.03.011. Epub 2012 Mar 23. PubMed 22449551 ↗
  • Touillet A, Gouzien A, Badin M, Herbe P, Martinet N, Jarrasse N, Roby-Brami A. Kinematic analysis of impairments and compensatory motor behavior during prosthetic grasping in below-elbow amputees. PLoS One. 2022 Nov 18;17(11):e0277917. doi: 10.1371/journal.pone.0277917. eCollection 2022. PubMed 36399487 ↗
  • Postema SG, Bongers RM, Brouwers MA, Burger H, Norling-Hermansson LM, Reneman MF, Dijkstra PU, van der Sluis CK. Musculoskeletal Complaints in Transverse Upper Limb Reduction Deficiency and Amputation in The Netherlands: Prevalence, Predictors, and Effect on Health. Arch Phys Med Rehabil. 2016 Jul;97(7):1137-45. doi: 10.1016/j.apmr.2016.01.031. Epub 2016 Feb 22. PubMed 26906238 ↗
  • Schone HR, Maimon Mor RO, Kollamkulam M, Szymanska MA, Gerrand C, Woollard A, Kang NV, Baker CI, Makin TR. Stable Cortical Body Maps Before and After Arm Amputation. bioRxiv [Preprint]. 2025 Feb 4:2023.12.13.571314. doi: 10.1101/2023.12.13.571314. PubMed 38168448 ↗
  • Flor H. Phantom-limb pain: characteristics, causes, and treatment. Lancet Neurol. 2002 Jul;1(3):182-9. doi: 10.1016/s1474-4422(02)00074-1. PubMed 12849487 ↗

Individual participant data

Plan to share: No

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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jun 24, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT07666204
Lead sponsor
Union de Gestion des Etablissements des Caisses d'Assurance Maladie - Nord Est
Collaborators
Institut des Sciences du Mouvement, Institut des Systèmes Intelligents et de Robotique, Laboratoire des Sciences du Numérique de Nantes, Institut de Recherche en Informatique et Systèmes Aléatoires
Responsible party
Sponsor
First posted
Jun 24, 2026
Start date
Apr 15, 2026
Primary completion
Apr 30, 2030 (estimated)
Completion
Apr 30, 2030 (estimated)
Last update
Jun 24, 2026

Study contacts

Amélie Touillet
Contact
amelie.touillet@ugecam.assurance-maladie.fr
+333 83 52 97 00
Jonathan Pierret, PhD
Contact
jonathan.pierret@ugecam.assurance-maladie.fr
+333 83 52 97 00

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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