Differences in myoelectric and body-powered upper-limb prostheses: Systematic literature review

Abstract

Abstract-The choice of a myoelectric or body-powered upper-limb prosthesis can be determined using factors including control, function, feedback, cosmesis, and rejection. Although body-powered and myoelectric control strategies offer unique functions, many prosthesis users must choose one. A systematic review was conducted to determine differences between myoelectric and body-powered prostheses to inform evidence-based clinical practice regarding prescription of these devices and training of users. A search of 9 databases identified 462 unique publications. Ultimately, 31 of them were included and 11 empirical evidence statements were developed. Conflicting evidence has been found in terms of the relative functional performance of body-powered and myoelectric prostheses. Body-powered prostheses have been shown to have advantages in durability, training time, frequency of adjustment, maintenance, and feedback; however, they could still benefit from improvements of control. Myoelectric prostheses have been shown to improve cosmesis and phantom-limb pain and are more accepted for light-intensity work. Currently, evidence is insufficient to conclude that either system provides a significant general advantage. Prosthetic selection should be based on a patient's individual needs and include personal preferences, prosthetic experience, and functional needs. This work demonstrates that there is a lack of empirical evidence regarding functional differences in upper-limb prostheses.

Neural interfaces for somatosensory feedback

“…Body-powered prostheses are often preferred over more functional electrical devices because the user can 'feel' the grip interaction with objects via referred sensation through the body harness operating the prosthesis [58]. The representative sensory information does not directly match the user's visual experience of the prosthesis, but does provide a sense of control and connection to the device.…”

“…The representative sensory information does not directly match the user's visual experience of the prosthesis, but does provide a sense of control and connection to the device. Despite the negative aspects of body-powered prostheses, including being limited to one active degree of freedom [59], limited range of motion [58,60] (e.g. reaching over shoulder can be nonfunctional), and cumbersome and uncomfortable nature of the body harness, 35% of users still prefer the body-powered prosthesis, possibly for improved feedback and referred sensation [4,58].…”

“…Despite the negative aspects of body-powered prostheses, including being limited to one active degree of freedom [59], limited range of motion [58,60] (e.g. reaching over shoulder can be nonfunctional), and cumbersome and uncomfortable nature of the body harness, 35% of users still prefer the body-powered prosthesis, possibly for improved feedback and referred sensation [4,58]. Powered prostheses have many functional advantages to body-powered devices, but unfortunately, the only somatosensory feedback is the forces applied to the residual limb through the socket, the audible feedback of the motors and visual feedback.…”

“…Powered prostheses have many functional advantages to body-powered devices, but unfortunately, the only somatosensory feedback is the forces applied to the residual limb through the socket, the audible feedback of the motors and visual feedback. Prosthetic choice is often a choice between either function or sensation [58].…”

Rehabilitation and multiple limb amputations: A clinical report of patients injured in combat

“…The reader is reminded to avoid gen eralizing from the prosthetic solutions presented in these case reports because they are based on only two individu als. Recent reviews address the functionality and utility of various classes of conventional and technologically advanced prosthetic devices [3,23,[25][26]. In general, more research is needed to help identify patient and injury characteristics that predict successful performance for various classes of conventional and technologically advanced devices.…”