Objectifying the Functional Advantages of Prosthetic Wrist Flexion

Bertels, Thomas; Schmalz, Thomas; Ludwigs, Eva

doi:10.1097/jpo.0b013e3181a10f46

Cited by 39 publications

(24 citation statements)

References 4 publications

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“…When integrating wrist flexion in a prosthetic arm, compensatory movements reduced in most of the cases [36]. Although studies varied in this finding [37], a stiff wrist seems to be associated with the presence of compensatory movements, and therefore possibly with the development of MSCs.…”

Section: Prevalence Of Mscsmentioning

confidence: 91%

Musculoskeletal complaints in individuals with finger or partial hand amputations in the Netherlands: a cross-sectional study

Bouma

Postema

Bongers

et al. 2017

Disability and Rehabilitation

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Purpose: To compare the prevalence of musculoskeletal complaints (MSCs) in individuals with finger or partial hand amputations (FPHAs) with a control group and to explore the effect and predictors of MSCs in individuals with FPHAs. Method: A questionnaire-based cross-sectional study was conducted. The primary outcome measures were: prevalence of MSCs, health status, pain-related disability, physical work demands, work productivity, and hand function. Results: The response rate was 61%. A comparable proportion of individuals with FPHAs (n ¼ 99) and controls (n ¼ 102) reported MSCs in the preceding 4 weeks (33% vs. 28%, respectively) or in the preceding year (37% vs. 33%, respectively). Individuals with FPHAs with MSCs experienced more pain than controls with MSCs. Regular occurrence of stump sensations and self-reported limited range of motion (ROM) of the wrist of the affected limb were predictors for MSCs in individuals with FPHAs. Conclusions: The prevalence of MSCs was comparable in individuals with FPHAs and controls. However, clinicians should pay special attention to the risk of developing MSCs in patients with stump sensations and limited ROM of the wrist of the affected limb. Future research should focus on the role of wrist movements and compensatory movements in the development of MSCs in individuals with FPHAs. ä IMPLICATIONS FOR REHABILITATIONThe prevalence of musculoskeletal complaints (MSCs) in individuals with finger or partial hand amputations (FPHAs) and control subjects was similar. Regular occurrence of stump sensations and limited range of motion of the wrist of the affected limb were predictors of developing MSCs in individuals with FPHAs. Clinicians should pay special attention to individuals with FPHAs with the presence of these predictors of developing MSCs. For a better understanding of the development of and treatment options for MSCs, future research focusing on the role of wrist function in the development of MSCs in individuals with FPHAs is necessary. ARTICLE HISTORY

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Section: Prevalence Of Mscsmentioning

confidence: 91%

Musculoskeletal complaints in individuals with finger or partial hand amputations in the Netherlands: a cross-sectional study

Bouma

Postema

Bongers

et al. 2017

Disability and Rehabilitation

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“…This implies that participants with the highest functional scores may also show movement behaviors that largely deviate from nondisabled behavior (i.e., extensive compensatory behavior), which is contrary to what we anticipated. Usually, the aim of rehabilitation is to reduce compensatory movements as much as possible [7,9] and to bring movement patterns back as close as possible to those of nondisabled movement patterns [14] to reduce load and strain on joints as well as to avoid injury and overuse. However, an alternative view on compensatory movements put forth by Latash and Anson is that these movements reflect a solution given the motor characteristics of the patient and the task [14].…”

Section: Discussionmentioning

confidence: 99%

“…These studies measure end point kinematics or joint angles in goal-directed reaching and grasping tasks. Specific characteristics of prosthetic movements and deviations from sound movements are addressed, such as compensatory movements [7,9]. Changes in movement patterns are needed to compensate for the impaired ability of the prosthesis user (compare with Latash and Anson [14]).…”

Section: Introductionmentioning

confidence: 99%

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Determining skill level in myoelectric prosthesis use with multiple outcome measures

Bouwsema

Kyberd

Hill

et al. 2012

JRRD

107

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Abstract-To obtain more insight into how the skill level of an upper-limb myoelectric prosthesis user is composed, the current study aimed to (1) portray prosthetic handling at different levels of description, (2) relate results of the clinical level to kinematic measures, and (3) identify specific parameters in these measures that characterize the skill level of a prosthesis user. Six experienced transradial myoelectric prosthesis users performed a clinical test (Southampton Hand Assessment Procedure [SHAP]) and two grasping tasks. Kinematic measures were end point kinematics, joint angles, grasp force control, and gaze behavior. The results of the clinical and kinematic measures were in broad agreement with each other. Participants who scored higher on the SHAP showed overall better performance on the kinematic measures. They had smaller movement times, had better grip force control, and needed less visual attention on the hand. The results showed that time was a key parameter in prosthesis use and should be one of the main focus aspects of rehabilitation. The insights from this study are useful in rehabilitation practice because they allow therapists to specifically focus on certain parameters that may result in a higher level of skill for the prosthesis user.

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“…The role of the user in selecting the device and the timeliness of delivery are significant factors in prosthesis acceptance [13]. Even a small change in the artificial limb can have significant effect on the overall body movements [16] and ultimately lead to a reduction in the rate of use of the intact body segments, possibly reducing overuse injuries. Limited function of prostheses may cause awkward aberrant movements not normally experienced by persons without amputation, called compensatory motion [17][18].…”

Section: Introductionmentioning

confidence: 99%

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

Carey

Lura

Highsmith³

et al. 2015

J Rehabil Res Dev

181

112

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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.

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Objectifying the Functional Advantages of Prosthetic Wrist Flexion

Cited by 39 publications

References 4 publications

Musculoskeletal complaints in individuals with finger or partial hand amputations in the Netherlands: a cross-sectional study

Musculoskeletal complaints in individuals with finger or partial hand amputations in the Netherlands: a cross-sectional study

Determining skill level in myoelectric prosthesis use with multiple outcome measures

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

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