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Differences in Myoelectric and Body-Powered Upper-Limb Prostheses: Systematic Literature Review Update 2013–2016
State of the Science Conference Findings
Keyword(s)
amputation, control strategy, prosthesis, rehabilitation, transhumeral, transradial
Prosthesis users often make a choice between a myoelectric or body-powered upper-limb prosthesis. The choice may be determined using factors such as cost, insurance limitations, function, sensory feedback, and cosmesis. An updated systematic review was conducted to determine differences between myoelectric and body-powered prostheses in the past 3 years (mid-2013 to 2016) since the previous review. An additional 43 unique publications were identified. Ultimately, three of the publications were included, adding evidence to two previously developed empirical evidence statements regarding the potential need for multiple control strategies to facilitate intuitive prosthetic control and the value of task training in improving function. However, there is still insufficient evidence to conclude that either the myoelectric or body-powered prosthesis provides an overall advantage. Although excluded from this literature review, research on hybrid prostheses such as the DEKA arm and on sensation and haptic feedback is emerging. There is still a need for more empirical evidence regarding functional differences in upper-limb prostheses. (J Prosthet Orthot. 2017;29:P17–P20)
Author(s)
Stephanie L. Carey, PhD; Phil M. Stevens, MEd, CPO, FAAOP; M. Jason Highsmith, PhD, DPT, CP, FAAOP
Description
It is well documented that the number of people living with an amputation is increasing, with the most recent estimates from 2005 suggesting that 41,000 individuals in the United States are living with major upper-limb loss. A study examining US service members from 2001 to 2011 reported that 14% of amputations involved the upper limb. Literature reports of rejection rates of upper-limb prostheses vary from 0% to 50% due to factors such as lack of perceived functional gains, prosthesis weight, and socket discomfort among others. Prosthetic prescription currently depends to varying degrees on patient input, the experience of treating clinicians with available components, literature on component function, manufacturer's claims, and reimbursement methods. The purpose of this updated systematic review was to determine if new evidence supporting the differences between myoelectric (MYO) and body-powered (BP) prostheses in the areas of functionality, control, and sensory feedback, cosmesis, and rejection has emerged since the previous review conducted in 2013.