0 Item(s)
Differences in Myoelectric and Body-Powered Upper-Limb Prostheses: Systematic Literature Review
State of the Science Conference Findings
Keyword(s)
amputation, artificial limb, control, cosmesis, external power, function, prosthesis, rehabilitation, transradial, transhumeral
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. (J Prosthet Orthot. 2017;29:P4–P16)
Author(s)
Stephanie L. Carey, PhD; Derek J. Lura, PhD; M. Jason Highsmith, DPT, PhD, CP, FAAOP
Description
In 2005, an estimated 1.6 million people in the United States were living with an amputation. This number is expected to increase to over 2.3 million by 2020. A more recent report already estimates an increase to 1.7 million people in just over 3 yr. A retrospective study examining amputations sustained by U.S. servicemembers from January 2001 through July 2011 reported that 14 percent of amputations involved the upper limb and that 10 percent of these involved more than one amputation. In 2004, interviews with members of the Amputee Coalition of America found nearly one-third of persons with amputation reported being dissatisfied with the comfort of their device, while 18.4 percent of respondents reported being fit with a new prosthesis at least once a year. Some reports suggest as many as 50 percent of persons with upper-limb amputation choose not to wear a prosthesis often citing that the functional advantage or cosmesis did not outweigh the discomfort or inconvenience of the device.