Background:Body-powered prostheses require cable operation forces between 33 and 131 N. The accepted upper limit for fatigue-free long-duration operation is 20% of a users’ maximum cable operation force. However, no information is available on users’ maximum force.Objectives:To quantify users’ maximum cable operation force and to relate this to the fatigue-free force range for the use of body-powered prostheses.Study design:Experimental trial.Methods:In total, 23 subjects with trans-radial deficiencies used a bypass prosthesis to exert maximum cable force three times during 3 s and reported discomfort or pain on a body map. Additionally, subjects’ anthropometric measures were taken to relate to maximum force.Results:Subjects generated forces ranging from 87 to 538 N. Of the 23 subjects, 12 generated insufficient maximum cable force to operate 8 of the 10 body-powered prostheses fatigue free. Discomfort or pain did not correlate with the magnitude of maximum force achieved by the subjects. Nine subjects indicated discomfort or pain. No relationships between anthropometry and maximal forces were found except for maximum cable forces and the affected upper-arm circumference for females.Conclusion:For a majority of subjects, the maximal cable force was lower than acceptable for fatigue-free prosthesis use. Discomfort or pain occurred in ~40% of the subjects, suggesting a suboptimal force transmission mechanism.Clinical relevanceThe physical strength of users determines whether a body-powered prosthesis is suitable for comfortable, fatigue-free long-duration use on a daily basis. High cable operation forces can provoke discomfort and pain for some users, mainly in the armpit. Prediction of the users’ strength by anthropometric measures might assist the choice of a suitable prosthesis.

Operating a body-powered prosthesis can be painful and tiring due to high cable operation forces, illustrating that low cable operation forces are a desirable design property for body-powered prostheses. However, lower operation forces might negatively affect controllability and force perception, which is plausible but not known. This study aims to quantify the accuracy of cable force perception and control for body-powered prostheses in a low cable operation force range by utilizing isometric and dynamic force reproduction experiments. Twenty-five subjects with trans-radial absence conducted two force reproduction tasks; first an isometric task of reproducing 10, 15, 20, 25, 30 or 40 N and second a force reproduction task of 10 and 20 N, for cable excursions of 10, 20, 40, 60 and 80 mm. Task performance was quantified by the force reproduction error and the variability in the generated force. The results of the isometric experiment demonstrated that increasing force levels enlarge the force variability, but do not influence the force reproduction error for the tested force range. The second experiment showed that increased cable excursions resulted in a decreased force reproduction error, for both tested force levels, whereas the force variability remained unchanged. In conclusion, the design recommendations for voluntary closing body-powered prostheses suggested by this study are to minimize cable operation forces: this does not affect force reproduction error but does reduce force variability. Furthermore, increased cable excursions facilitate users with additional information to meet a target force more accurately.

BackgroundIt is generally asserted that reliable and intuitive control of upper-limb prostheses requires adequate feedback of prosthetic finger positions and pinch forces applied to objects. Body-powered prostheses (BPPs) provide the user with direct proprioceptive feedback. Currently available BPPs often require high cable operation forces, which complicates control of the forces at the terminal device. The aim of this study is to quantify the influence of high cable forces on object manipulation with voluntary-closing prostheses.MethodAble-bodied male subjects were fitted with a bypass-prosthesis with low and high cable force settings for the prehensor. Subjects were requested to grasp and transfer a collapsible object as fast as they could without dropping or breaking it. The object had a low and a high breaking force setting.ResultsSubjects conducted significantly more successful manipulations with the low cable force setting, both for the low (33% more) and high (50%) object’s breaking force. The time to complete the task was not different between settings during successful manipulation trials.ConclusionHigh cable forces lead to reduced pinch force control during object manipulation. This implies that low cable operation forces should be a key design requirement for voluntary-closing BPPs.

No abstract

Background:Body-powered prosthesis users frequently complain about the poor cosmesis and comfort of the traditional shoulder harness. The Ipsilateral Scapular Cutaneous Anchor System offers an alternative, but it remains unclear to what extent it affects the perception and control of cable operation forces compared to the traditional shoulder harness.Objective:To compare cable force perception and control with the figure-of-nine harness versus the Ipsilateral Scapular Cutaneous Anchor System and to investigate force perception and control at different force levels.Study design:Experimental trial.Methods:Ten male able-bodied subjects completed a cable force reproduction task at four force levels in the range of 10–40 N using the figure-of-nine harness and the Anchor System. Perception and control of cable operating forces were quantified by the force reproduction error and the force variability.Results:In terms of force reproduction error and force variability, the subjects did not behave differently when using the two systems. The smallest force reproduction error and force variability were found at the smallest target force level of 10 N.Conclusion:The Anchor System performs no differently than the traditional figure-of-nine harness in terms of force perception and control, making it a viable alternative. Furthermore, users perceive and control low operation forces better than high forces.Clinical relevanceThe Ipsilateral Scapular Cutaneous Anchor System offers an alternative for the traditional harness in terms of cable operation force perception and control and should therefore be considered for clinical use.Low cable operation forces increase the perception and control abilities of users.