Perceptions of cosmesis and function in adults with upper limb prostheses: a systematic literature review

2011 ◽  
Vol 35 (4) ◽  
pp. 332-341 ◽  
Author(s):  
Sophie Ritchie ◽  
Sally Wiggins ◽  
Alison Sanford
Keyword(s):  
Upper Limb ◽  
User Satisfaction ◽  
Future Design ◽  
Prosthetic Limb ◽  
Upper Limb Prosthesis ◽  
Upper Limb Prostheses ◽  
Technological Developments ◽  
User Groups ◽  
And Function ◽  
Satisfaction Rates

Background: Technological developments in prosthesis design of upper limb devices are improving rapidly, and understandings of user’s perceptions are important to reduce device abandonment and improve user satisfaction rates.Objectives: The purpose of this review was to establish what is known about adult user’s perceptions of upper limb prostheses in terms of both cosmesis and function.Study Design: Systematic review.Methods: A search of the literature between 1990 and 2010 identified over 600 possible citations; these were reduced to 15 citations based on selection criteria.Results: The main themes arising from the review were user satisfaction ratings with current prostheses, priorities for future design and the social implications of wearing a prosthetic limb. While users of cosmetic prostheses were mostly satisfied with their prostheses, satisfaction rates vary considerably across studies, due to variability in demographics of users and an ambiguity over the definitions of cosmesis and function. Design priorities also varied, though overall there is a slight trend toward prioritising function over cosmesis. The qualitative studies noted the importance users placed on presenting a ‘normal’ appearance and ‘not standing out’.Conclusions: The reviewed studies mostly examine functionality and cosmesis as separate constructs, and conclusions are limited due to the disparity of user groups studied. Recommendations are made for further work to explore understandings of these constructs in relation to upper limb prosthesis use.

scholarly journals Prosthetic limb use in Australia 1981-1985 under the Free Limb Scheme

1989 ◽  
Vol 13 (2) ◽  
pp. 76-81 ◽  
Author(s):  
L. E. Jones
Keyword(s):  
Upper Limb ◽  
Lower Limb ◽  
Knee Prosthesis ◽  
Knee Prostheses ◽  
Prosthetic Limb ◽  
Prosthetic Limbs ◽  
Upper Limb Prosthesis ◽  
Upper Limb Prostheses ◽  
Lower Limb Prosthesis ◽  
Limb Prosthesis

A study has been made of data on 19,421 prosthetic limbs prescribed for 12,143 Australians under the Free Limb Scheme in the years 1981–1985. These prostheses consisted of 18,119 legs and 1,302 arms. The mean age of the lower limb prosthesis user was 52.8 and the upper limb prosthesis user 31.3 years. Males outnumbered females by 3 to 1 in the upper limb prosthesis users, and 2.8 to 1 with lower limb prosthesis users. Below-knee prostheses, patellar-tendon-bearing and thigh-lacing prostheses, made up 58.7% of all prostheses prescribed in the time span. Below-elbow prostheses were the commonest upper limb prostheses with children being the most frequent users. Comparisons with other studies of large number of prosthesis users show an older mean age in Australia and more below-knee prosthesis users than in American studies.

scholarly journals Optimizing strap designs of upper limb prostheses

2018 ◽  
Vol 10 (7) ◽  
pp. 168781401878926
Author(s):  
Ying Liu ◽  
Xiufeng Zhang ◽  
Ning Zhang ◽  
Jianguang Xu ◽  
Rong Yang
Keyword(s):  
Upper Limb ◽  
Original Problem ◽  
Mechanical Analysis ◽  
Equilibrium Equations ◽  
Prosthetic Socket ◽  
Upper Limb Prosthesis ◽  
Upper Limb Prostheses ◽  
Discipline Problem ◽  
The Individual ◽  
Limb Prosthesis

The precise positioning design of upper limb prostheses is important for patients with upper limb disability. In this study, we propose an upper limb prosthesis with a negative pressure design. Mechanical analysis is performed to obtain the force and moment equilibrium equations. Then, the individual discipline feasible method is performed to decouple the original problem into a three-sub-discipline problem. A minimum of three shoulder straps of tension is obtained during optimization using the Isight harness scheme. The prosthetic socket can be firmly attached to the human body. Further experiments verify that the proposed device meets the basic requirements of wearing.

Internal models of upper limb prosthesis users when grasping and lifting a fragile object with their prosthetic limb

2014 ◽  
Vol 232 (12) ◽  
pp. 3785-3795 ◽  
Author(s):  
Peter S. Lum ◽  
Iian Black ◽  
Rahsaan J. Holley ◽  
Jessica Barth ◽  
Alexander W. Dromerick
Keyword(s):  
Upper Limb ◽  
Internal Models ◽  
Prosthetic Limb ◽  
Upper Limb Prosthesis ◽  
Fragile Object ◽  
Limb Prosthesis

scholarly journals An Electromyographically Controlled Elbow Locking Mechanism for an Upper Limb Prosthesis

1983 ◽  
Vol 10 (2-3) ◽  
pp. 87-93 ◽  
Author(s):  
H. T. Law ◽  
J. J. Hewson
Keyword(s):  
Upper Limb ◽  
Upper Arm ◽  
Hybrid Technology ◽  
Electronic Circuitry ◽  
Upper Limb Prosthesis ◽  
Locking Mechanism ◽  
Upper Limb Prostheses ◽  
Mechanical Devices ◽  
Limb Prosthesis

The purpose of the elbow lock incorporated in an artificial arm is discussed and the difficulties encountered in the operation of purely mechanical devices are outlined. An electrically driven locking mechanism has been built which is controlled by the electromyogram (e.m.g.) of the surviving muscles in the upper arm. Hybrid technology is ideally suited to the construction of the associated electronic circuitry and to many similar applications now being considered in attempts to improve the performance of upper-limb prostheses.

scholarly journals Evaluation of important factors in accepts or reject of upper limb prosthesis in children

2016 ◽  
pp. 65-72
Author(s):  
Meria Yazdani
Keyword(s):  
Upper Limb ◽  
Control Method ◽  
Group Method ◽  
Elbow Prosthesis ◽  
Future Design ◽  
Upper Limb Prosthesis ◽  
Population Type ◽  
Prosthesis Control ◽  
Limb Prosthesis

Abstract Introduction: upper limb amputee Children usually uses prosthesis for better function. But studies show a high percentage of rejection of the prosthesis in this group. In clinical studies, there are not very different in function of children who use of prosthesis and those who do not. Answer to why children accept and use their prosthesis or reject it could help and improve the future design of the prosthesis and rehabilitation. The aim of this study was finding important criteria for children with below elbow amputation, their parents and therapists for acceptance and use of prosthetics or rejects it in children group. Method: This study was conducted by literature search of Science direct, Google Scholar, Cochran Library, MEDLINE and PubMed between 1966 and 2014 ,that investigated effective factors in accept or reject of below elbow prosthesis in below elbow amputee children.For quality assessment of articles we rated each paper using the Downs and Black score ranges and Pedro scale . The two reviewers independently read and classified the articles by population, type of study and results. Results After initial evaluation and reviews, 14 articles were included in this study. Most studies were reported form and questionnaire and clinical observations.The general characteristics of the prosthesis, prosthesis control method, quality of life, family and the rehabilitation procedures were important factors were explored in these literature. Conclusion According to the studies, it is necessary to optimize the prosthesis according to the real children expectations and needs to improve their quality of life.There are controversial studies about performance and first time prosthesis in children but studies confirmed that Group therapy can increase the acceptance rate of prosthesis. Training and finding ways for function without prosthesis along using it to communicate with the environment, increase motor control and sensory perception that could increase accept of prosthesis in children. Keywords: upper limb prosthesis, children, amputation

scholarly journals Smartphone supported upper limb prosthesis

2015 ◽  
Vol 1 (1) ◽  
pp. 484-487
Author(s):  
D. Hepp ◽  
J. Kirsch ◽  
F. Capanni
Keyword(s):  
Neural Network ◽  
Upper Limb ◽  
Design Development ◽  
Test Setup ◽  
Software Application ◽  
Patient Feedback ◽  
Emg Signal ◽  
Upper Limb Prosthesis ◽  
Upper Limb Prostheses ◽  
Limb Prosthesis

AbstractState of the art upper limb prostheses offer up to six active DoFs (degrees of freedom) and are controlled using different grip patterns. This low number of DoFs combined with a machine-human-interface which does not provide control over all DoFs separately result in a lack of usability for the patient. The aim of this novel upper limb prosthesis is both offering simplified control possibilities for changing grip patterns depending on the patients’ priorities and the improvement of grasp capability. Design development followed the design process requirements given by the European Medical Device Directive 93/42 ECC and was structured into the topics mechanics, software and drive technology. First user needs were identified by literature research and by patient feedback. Consequently, concepts were evaluated against technical and usability requirements. A first evaluation prototype with one active DoF per finger was manufactured. In a second step a test setup with two active DoF per finger was designed. The prototype is connected to an Android based smartphone application. Two main grip patterns can be preselected in the software application and afterwards changed and used by the EMG signal. Three different control algorithms can be selected: “all-day”, “fine” and “tired muscle”. Further parameters can be adjusted to customize the prosthesis to the patients’ needs. First patient feedback certified the prosthesis an improved level of handling compared to the existing devices. Using the two DoF test setup, the possibilities of finger control with a neural network are evaluated at the moment. In a first user feedback test, the smartphone based software application increased the device usability, e.g. the change within preselected grip patterns and the “tired muscle” algorithm. Although the overall software application was positively rated, the handling of the prosthesis itself needs to be proven within a patient study to be performed next. The capability of the neural network to control the hand has also to be proven in a next step.

scholarly journals Adaptive Windowing Framework for Surface Electromyogram-Based Pattern Recognition System for Transradial Amputees

Sensors ◽  
2018 ◽  
Vol 18 (8) ◽  
pp. 2402 ◽  
Author(s):  
Ali Al-Timemy ◽  
Guido Bugmann ◽  
Javier Escudero
Keyword(s):  
Pattern Recognition ◽  
Upper Limb ◽  
Time Domain ◽  
Window Size ◽  
Error Rates ◽  
Classification Error ◽  
Linear Discriminant ◽  
Emg Signal ◽  
Upper Limb Prosthesis ◽  
Upper Limb Prostheses

Electromyogram (EMG)-based Pattern Recognition (PR) systems for upper-limb prosthesis control provide promising ways to enable an intuitive control of the prostheses with multiple degrees of freedom and fast reaction times. However, the lack of robustness of the PR systems may limit their usability. In this paper, a novel adaptive time windowing framework is proposed to enhance the performance of the PR systems by focusing on their windowing and classification steps. The proposed framework estimates the output probabilities of each class and outputs a movement only if a decision with a probability above a certain threshold is achieved. Otherwise (i.e., all probability values are below the threshold), the window size of the EMG signal increases. We demonstrate our framework utilizing EMG datasets collected from nine transradial amputees who performed nine movement classes with Time Domain Power Spectral Descriptors (TD-PSD), Wavelet and Time Domain (TD) feature extraction (FE) methods and a Linear Discriminant Analysis (LDA) classifier. Nonetheless, the concept can be applied to other types of features and classifiers. In addition, the proposed framework is validated with different movement and EMG channel combinations. The results indicate that the proposed framework works well with different FE methods and movement/channel combinations with classification error rates of approximately 13% with TD-PSD FE. Thus, we expect our proposed framework to be a straightforward, yet important, step towards the improvement of the control methods for upper-limb prostheses.

scholarly journals Refined clothespin relocation test and assessment of motion

2016 ◽  
Vol 41 (3) ◽  
pp. 294-302 ◽  
Author(s):  
Ali Hussaini ◽  
Peter Kyberd
Keyword(s):  
Upper Limb ◽  
Degrees Of Freedom ◽  
Assessment Tools ◽  
Single Degree Of Freedom ◽  
End Effector ◽  
Upper Limb Prosthesis ◽  
Compensatory Motion ◽  
User Groups ◽  
Motion Studies ◽  
Limb Prosthesis

Background:Advancements in upper limb prosthesis design have focused on providing increased degrees of freedom for the end effector through multiple articulations of a prosthetic hand, wrist and elbow. Measuring improvement in patient function with these devices requires development of appropriate assessment tools.Objectives:This study presents a refined clothespin relocation test for measuring performance and assessing compensatory motion between able-bodied subjects and subjects with upper limb impairments.Study design:Comparative analysis.Methods:Trunk and head motions of 13 able-bodied subjects who performed the refined clothespin relocation test were compared to the motion of a transradial prosthesis user with a single degree of freedom hand.Results:There were observable differences between the prosthesis user and the able-bodied group. The assessment used provided a clear indication of the differences in motion through analysis of compensatory motion.Conclusion:The refined clothespin relocation test provides additional benefits over the standard clothespin assessment and makes identification of compensatory motions easily identifiable to the researcher. While this article establishes the method for the new assessment, further validation will need to be performed with more users.Clinical relevanceThe refined test provides a more defined structure for the trajectory of the hand/terminal device than the standard protocol for the clothespin relocation test. This will help researchers interested in motion studies of limb segments to efficiently compare and analyse motion between able-bodied and prosthesis user groups.

scholarly journals Survey of upper limb prosthesis users in Sweden, the United Kingdom and Canada

2011 ◽  
Vol 35 (2) ◽  
pp. 234-241 ◽  
Author(s):  
Peter J Kyberd ◽  
Wendy Hill
Keyword(s):  
Upper Limb ◽  
Postal Questionnaire ◽  
Single Factor ◽  
Chi Square ◽  
Prosthetic Devices ◽  
The United Kingdom ◽  
Upper Limb Prosthesis ◽  
Upper Limb Prostheses ◽  
Different Types ◽  
Limb Prosthesis

Background: As part of the process of improving prosthetic arms, it is important to obtain the opinions of the user population.Objectives: To identify factors that should be focused on to improve prosthesis provision.Study design: Postal questionnaire.Methods: The questionnaire was sent to 292 adults (aged 18 to 70 years) with upper-limb loss or absence at five centres (four in Europe) Participants were identified as regular attendees of the centres.Results: This questionnaire received a response from 180 users (response rate 62%) of different types of prosthetic devices. Responses showed that the type of prosthesis generally used was associated with gender, level of loss and use for work (Pearson chi-square, p-values below 0.05). The type of prosthesis was not associated with cause, side, usage (length per day, sports or driving) or reported problems. The findings did not identify any single factor requiring focus for the improvement of prostheses or prosthetic provision.Conclusions: Every part of the process of fitting a prosthesis can be improved, which will have an effect for some of the population who use their devices regularly. There is, however, no single factor that would bring greater improvement to all users.Clinical relevance Based on information gained from a broad range of prosthesis users, no single aspect of prosthetic provision will have a greater impact on the use of upper limb prostheses than any other. Efforts to improve the designs of prosthetic systems can cover any aspect of provision.

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