# PWR-211 — Neural sensory feedback: learner worksheet Release: Revision 7T · Full Tutorial Edition Estimated time: Estimated 14 min reading; practical time is provider-set Difficulty: Intermediate Equipment: Common household or practice equipment — Declared Neural sensory feedback fixture: An approved prosthetic-hand setup pairs three labelled feedback states—open, light contact and firm contact—with clinician-controlled neural or simulated stimulation. An empty paper cup is the only object.; Setup aid for Check interface and stimulation authority: Verify approved interface, stimulator limits, force limits, emergency stop and empty safe object.; Neural sensory feedback log: Force error, object identification, visual-attention burden, sensation stability, adverse events and unfamiliar-task performance device-on/off; retain Neural sensory feedback errors, assistance, stop and fallback.; Sensory-feedback provider table: use “Self-Contained Neuromusculoskeletal Arm Prostheses” to record the complete prosthesis configuration and trained function. From “Intraneural sensory feedback restores grip force control and motor coordination while using a prosthetic hand”, extract feedback code, task, device-on comparison and adverse-event reporting. Apply NIST privacy fields to neural records; the clinician alone controls stimulation. Space: Room-scale practice space Automated structural checklist: 10 of 10 structural checks present Evidence quality/context: G4; Deep research depth Automated method-quality band: Comprehensive Method-rating basis: Structure coverage, instruction/check specificity, alternative distinctness, source troubleshooting, comparison depth and whether purpose/check fields are authored rather than derived. Editorial review: Pending manual editorial sign off ## Before you begin - [ ] I read the tutorial authority and stop conditions. - [ ] I have the required equipment/space or a declared accessible alternative. ## Canonical source context A clinician pairs open, light-contact and firm-contact feedback states, then tests them blindly before one low-force paper-cup grasp. The learner can answer uncertain, pause stimulation and compare visual demand and force with feedback on and off. Discriminating this code is not natural sensation or proof of safety with other objects. Target outcome: With the clinical team, the learner discriminates provider-set feedback levels, uses them in one low-force grasp and reports false sensations, discomfort and device-on versus device-off performance. ### Authority and setup conditions - Obtain clinical/research approval and participant confirmation through a reliable communication channel. - Verify approved interface, stimulator limits, force limits, emergency stop and empty safe object. - Start check for Neural sensory feedback: The code serves one user-chosen action and no pain threshold test. - Top-of-sheet stop for Neural sensory feedback: Stop for pain, burning, shocking discomfort, unexpected spread, skin change, new neurological symptom, distress or withdrawal. ### Required or supplied materials - Declared Neural sensory feedback fixture: An approved prosthetic-hand setup pairs three labelled feedback states—open, light contact and firm contact—with clinician-controlled neural or simulated stimulation. An empty paper cup is the only object. - Setup aid for Check interface and stimulation authority: Verify approved interface, stimulator limits, force limits, emergency stop and empty safe object. - Neural sensory feedback log: Force error, object identification, visual-attention burden, sensation stability, adverse events and unfamiliar-task performance device-on/off; retain Neural sensory feedback errors, assistance, stop and fallback. - Sensory-feedback provider table: use “Self-Contained Neuromusculoskeletal Arm Prostheses” to record the complete prosthesis configuration and trained function. From “Intraneural sensory feedback restores grip force control and motor coordination while using a prosthetic hand”, extract feedback code, task, device-on comparison and adverse-event reporting. Apply NIST privacy fields to neural records; the clinician alone controls stimulation. ## 1. Choose the functional distinction The participant and team select open, light and firm contact and define a safe grasp range and stop signal. Why: The code serves one user-chosen action and no pain threshold test. Success check: The code serves one user-chosen action and no pain threshold test. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “The code serves one user-chosen action and no pain threshold test.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 2. Check interface and stimulation authority The clinician verifies implant or simulator status, skin, health, stimulator limits, charge/setting control and emergency response. Why: Only authorised staff can set stimulation. Success check: Only authorised staff can set stimulation. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “Only authorised staff can set stimulation.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 3. Establish a no-feedback baseline With visual feedback, attempt the paper-cup grasp and record force error, corrections and attention burden. Why: Device-off comparator is preserved. Success check: Device-off comparator is preserved; verify it in the three-state sensory-feedback grasp. Accessible alternative: A spoken or tactile version of “With visual feedback, attempt the paper-cup grasp and record force error, corrections and attention burden.” can rehearse the response sequence, but it removes the declared visual stimulus and is therefore a related activity, not an equivalent attempt at Neural sensory feedback. To preserve the target, keep the authored visual stimulus and adapt only non-target access such as response input, instructions, breaks or support; retain this success check: “Device-off comparator is preserved; verify it in the three-state sensory-feedback grasp.” Alternative relationship: Related alternative changes trained or measured target Learner notes: ________________________________________________________________________________ Completed: [ ] ## 4. Pair one labelled state at a time The clinician presents each approved state with its label at a comfortable setting and checks participant report. Why: The participant can pause or reject a state and no setting is increased independently. Success check: The participant can pause or reject a state and no setting is increased independently. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “The participant can pause or reject a state and no setting is increased independently.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 5. Run blinded discrimination Randomise provider-set open, light and firm trials and record response, confidence, false sensation, adaptation and discomfort. Why: A complete confusion table shows which states are confused. Success check: A complete confusion table shows which states are confused. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “A complete confusion table shows which states are confused.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 6. Use feedback in the grasp Under force and motion limits, close until light contact is reported, hold and release the empty cup. Why: Cup is not crushed or dropped and force stays inside the approved band. Success check: Cup is not crushed or dropped and force stays inside the approved band. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “Cup is not crushed or dropped and force stays inside the approved band.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 7. Test false certainty Include a no-stimulation trial; the learner may answer “uncertain” rather than forcing a state. Why: No-stimulation false reports are visible and do not trigger extra force. Success check: No-stimulation false reports are visible and do not trigger extra force. Accessible alternative: Ask the qualified provider to adapt positioning, cue modality, pace, interface or rest while preserving this step’s declared check: “No-stimulation false reports are visible and do not trigger extra force.” If an adaptation changes the measured task or configuration, record it as a different configuration rather than an equivalent attempt. Alternative relationship: Conditional equivalence requires target and configuration check Learner notes: ________________________________________________________________________________ Completed: [ ] ## 8. Compare and finish Record force error, visual attention, discrimination, symptoms and device-on/off result, then the clinician returns the system to safe state. Why: Any claimed benefit is bounded to this task and configuration. Success check: Any claimed benefit is bounded to this task and configuration. Accessible alternative: A spoken or tactile version of “Record force error, visual attention, discrimination, symptoms and device-on/off result, then the clinician returns the system to safe state.” can rehearse the response sequence, but it removes the declared visual stimulus and is therefore a related activity, not an equivalent attempt at Neural sensory feedback. To preserve the target, keep the authored visual stimulus and adapt only non-target access such as response input, instructions, breaks or support; retain this success check: “Any claimed benefit is bounded to this task and configuration.” Alternative relationship: Related alternative changes trained or measured target Learner notes: ________________________________________________________________________________ Completed: [ ] ## Reflection What changed? ________________________________________________________________________________ What remains difficult? ________________________________________________________________________________ What will I repeat, adapt, ask for help with, or stop? ________________________________________________________________________________ --- Completion of this worksheet demonstrates tutorial participation only. It does not establish capability, qualification, safety clearance, diagnosis, treatment or independent validation.