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Myoelectric versus Body-Powered Upper-Limb Prostheses: A Clinical Perspective
State of the Science Conference Findings
Keyword(s)
upper-limb prosthesis, myoelectric, body powered, prosthesis
The major considerations in upper-limb prosthetic rehabilitation can be characterized as cosmesis, comfort, and control. Although these proceedings were focused largely on control, this single consideration must not occur at the exclusion of the other two. The indications, benefits, contraindications, and drawbacks associated with the major control variants of myoelectric, body-powered, and hybrid prostheses will be discussed from the perspective of the clinical prosthetist. Although centered on the care of the individual with unilateral transradial amputation, considerations in the management for more proximal amputations levels will be presented. In addition, those obstacles that may interfere with the procurement of the most appropriate control option are presented. (J Prosthet Orthot. 2017;29:P25–P29)
Author(s)
Jack Uellendahl, CPO
Description
The basic requirements of an upper-limb prosthesis can be described by three things: cosmesis, comfort, and control. The focus of this conference was on the control aspect of prosthetic use: myoelectric versus body-powered. However, prosthetic control influences both cosmesis and comfort. For most users of upper-limb prostheses, cosmetic function is of primary importance, and this is certainly true in the beginning of rehabilitation. Cosmetic function refers to the natural appearance of the prosthesis and, thus, to the perceived degree of unobtrusiveness of the individual with an amputation with his/ her prosthesis. Van Lunteren et al. break down cosmetic function into three categories: passive cosmesis, cosmesis of wearing, and cosmesis of use. They found that most persons with amputation found passive cosmesis to be very important. Those highly concerned about the cosmesis of wearing may tend to hide their prosthesis and those concerned with cosmesis of use tend to avoid activities that require unnatural arm motions. The comfort of an upper-limb prosthesis is also extremely important as the discomfort associated with harnessing and socket interface can quickly negate advantages in functional control. Thus, any considerations of prosthetic control options must include the associated influences of cosmesis and comfort.