scholarly journals Movement quality of conventional prostheses and the DEKA Arm during everyday tasks

2016 ◽  
Vol 41 (1) ◽  
pp. 33-40 ◽  
Author(s):  
Jeffrey Cowley ◽  
Linda Resnik ◽  
Jason Wilken ◽  
Lisa Smurr Walters ◽  
Deanna Gates
Keyword(s):  
Upper Limb ◽  
Wrist Joint ◽  
Case Series ◽  
Prosthetic Devices ◽  
Movement Quality ◽  
Prosthetic Limb ◽  
Upper Limb Prosthesis ◽  
Quantitative Analyses ◽  
Joint Center

Background:Conventional prosthetic devices fail to restore the function and characteristic movement quality of the upper limb. The DEKA Arm is a new, advanced prosthesis featuring a compound, powered wrist and multiple grip configurations.Objectives:The purpose of this study was to determine if the DEKA Arm improved the movement quality of upper limb prosthesis users compared to conventional prostheses.Study design:Case series.Methods:Three people with transradial amputation completed tasks of daily life with their conventional prosthesis and with the DEKA Arm. A total of 10 healthy controls completed the same tasks. The trajectory of the wrist joint center was analyzed to determine how different prostheses affected movement duration, speed, smoothness, and curvature compared to patients’ own intact limbs and controls.Results:Movement quality decreased with the DEKA Arm for two participants, and increased for the third. Prosthesis users made slower, less smooth, more curved movements with the prosthetic limb compared to the intact limb and controls, particularly when grasping and manipulating objects.Conclusion:The effects of one month of training with the DEKA Arm on movement quality varied with participants’ skill and experience with conventional prostheses. Future studies should examine changes in movement quality after long-term use of advanced prostheses.Clinical relevanceMovement quality with the DEKA Arm may depend on the user’s previous experience with conventional prostheses. Quantitative analyses are needed to assess the efficacy of novel prosthetic devices and to better understand how to train people to use them effectively.

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.

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

Systems in Prosthetic Hands and the Relationship With Their Performance

2013 ◽  
Author(s):  
Julio C. Díaz-Montes ◽  
Jesús Manuel Dorador-González
Keyword(s):  
Upper Limb ◽  
State Of The Art ◽  
The State ◽  
Prosthetic Devices ◽  
Prosthetic Hands ◽  
Upper Limb Prosthesis ◽  
The Relationship ◽  
Limb Prosthesis ◽  
The Way

A review of the state of the art in prosthetic hands is presented; this review covers the most common commercial prosthesis and prototypes under development. In this analysis, prosthetic devices were divided in six systems: actuation, reduction, blocking, transmission, flexion and support. The information obtained is presented according to those systems. The most important features of each system are presented together with their relationship with the performance of the entire prosthesis. An analysis that indicates the way in which prosthesis take advantage of the capabilities of current technologies is presented. Recommendations for improving the performance of upper limb prosthesis are proposed.

scholarly journals Application of Low-Intensity Modified Constraint-Induced Movement Therapy to Improve the Affecter Upper Limb Functionality in Infantile Hemiplegia with Moderate Manual Ability. Case Series

2020 ◽  
Author(s):  
Rocío Palomo-Carrión ◽  
Rita-Pilar Romero-Galisteo ◽  
Elena Piñero-Pinto ◽  
Purificación López-Muñoz ◽  
Helena Romay-Barrero ◽  
...  
Keyword(s):  
Upper Limb ◽  
Case Series ◽  
Movement Therapy ◽  
Low Intensity ◽  
Constraint Induced Movement Therapy ◽  
Case Series Study ◽  
Quality Of Movement ◽  
Prospective Case Series ◽  
Quest Scale

Objective: To assess the functionality of the affected upper limb in children diagnosed with hemiplegia aged between 4 and 8 years after applying low-intensity modified constraint-induced movement therapy(mCIMT). Methods: Prospective case series study. A mCIMT protocol was applied for five weeks, with two hours of containment per day. The study variables were: quality of movement of the upper limb, spontaneous use, participation of the affected upper limb in activities of daily living, dynamic joint position, grasp-release action, grasp strength, supination and extension elbow movements. Four measurements were performed, using the QUEST scale, the SHUEE Evaluation, a hand dynamometer and a goniometer. Results: The sample was composed of 8 children with moderate manual ability. Statistically significant differences were detected in all the studied variables (p<0.05). The greatest increase occurred in spontaneous use from assessment 1-4 (p = 0.01), reaching 88.87% active participation in bimanual tasks. The quality of movement of the upper limb obtained a significant value due to the increase in dissociated movements and grasp (p = 0.01). Conclusion: A low dose (50 hours) of mCIMT increased the functionality of children diagnosed with congenital hemiplegia between 4 and 8 years of age with moderate manual ability.

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 Does My Neck Make Me Clumsy? A Systematic Review of Clinical and Neurophysiological Studies in Humans

2021 ◽  
Vol 2 ◽  
Author(s):  
Samantha C. Harman ◽  
Zhen Zheng ◽  
Julie C. Kendall ◽  
Dein Vindigni ◽  
Barbara I. Polus
Keyword(s):  
Neck Pain ◽  
Upper Limb ◽  
Case Series ◽  
Objective Measures ◽  
Cross Sectional ◽  
Kinesthetic Sense ◽  
Neurophysiological Studies ◽  
Healthy Cohort ◽  
Sensorimotor Performance

Introduction: Clumsiness has been described as a symptom associated with neck pain and injury. However, the actuality of this symptom in clinical practice is unclear. The aim of this investigation was to collect definitions and frequency of reports of clumsiness in clinical studies of neck pain/injury, identify objective measures of clumsiness and investigate the association between the neck and objective measures of clumsiness.Methods: Six electronic databases were systematically searched, records identified and assessed including a risk of bias. Heterogeneity in designs of studies prevented pooling of data, so qualitative analysis was undertaken.Results: Eighteen studies were retrieved and assessed; the overall quality of evidence was moderate to high. Eight were prospective cross-sectional studies comparing upper limb sensorimotor task performance and ten were case series involving a healthy cohort only. Clumsiness was defined as a deficit in coordination or impairment of upper limb kinesthesia. All but one of 18 studies found a deterioration in performing upper limb kinesthetic tasks including a healthy cohort where participants were exposed to a natural neck intervention that required the neck to function toward extreme limits.Conclusion: Alterations in neck sensory input occurring as a result of requiring the neck to operate near the end of its functional range in healthy people and in patients with neck pain/injury are associated with reductions in acuity of upper limb kinesthetic sense and deterioration in sensorimotor performance. Understanding the association between the neck and decreased accuracy of upper limb kinesthetic tasks provide pathways for treatment and rehabilitation strategies in managing clumsiness.

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.

scholarly journals Co-creation and User Perspectives for Upper Limb Prosthetics

2021 ◽  
Vol 15 ◽  
Author(s):  
Hannah Jones ◽  
Sigrid Dupan ◽  
Matthew Dyson ◽  
Agamemnon Krasoulis ◽  
Laurence P. J. Kenney ◽  
...  
Keyword(s):  
Upper Limb ◽  
User Involvement ◽  
Research Process ◽  
Clinical Service ◽  
Rehabilitation Centre ◽  
Prosthetic Devices ◽  
Upper Limb Prosthesis ◽  
User Perspectives ◽  
Limb Prosthesis ◽  
Upper Limb Prosthetics

People who either use an upper limb prosthesis and/or have used services provided by a prosthetic rehabilitation centre, experience limitations of currently available prosthetic devices. Collaboration between academia and a broad range of stakeholders, can lead to the development of solutions that address peoples' needs. By doing so, the rate of prosthetic device abandonment can decrease. Co-creation is an approach that can enable collaboration of this nature to occur throughout the research process. We present findings of a co-creation project that gained user perspectives from a user survey, and a subsequent workshop involving: people who use an upper limb prosthesis and/or have experienced care services (users), academics, industry experts, charity executives, and clinicians. The survey invited users to prioritise six themes, which academia, clinicians, and industry should focus on over the next decade. The prioritisation of the themes concluded in the following order, with the first as the most important: function, psychology, aesthetics, clinical service, collaboration, and media. Within five multi-stakeholder groups, the workshop participants discussed challenges and collaborative opportunities for each theme. Workshop groups prioritised the themes based on their discussions, to highlight opportunities for further development. Two groups chose function, one group chose clinical service, one group chose collaboration, and another group chose media. The identified opportunities are presented within the context of the prioritised themes, including the importance of transparent information flow between all stakeholders; user involvement throughout research studies; and routes to informing healthcare policy through collaboration. As the field of upper limb prosthetics moves toward in-home research, we present co-creation as an approach that can facilitate user involvement throughout the duration of such studies.

scholarly journals Application of Low-Intensity Modified Constraint-Induced Movement Therapy to Improve the Affected Upper Limb Functionality in Infantile Hemiplegia with Moderate Manual Ability: Case Series

Children ◽  
2020 ◽  
Vol 7 (9) ◽  
pp. 127
Author(s):  
Rocío Palomo-Carrión ◽  
Rita-Pilar Romero-Galisteo ◽  
Elena Pinero-Pinto ◽  
Purificación López-Muñoz ◽  
Helena Romay-Barrero ◽  
...  
Keyword(s):  
Upper Extremity ◽  
Upper Limb ◽  
Case Series ◽  
Movement Therapy ◽  
Low Intensity ◽  
Constraint Induced Movement Therapy ◽  
Case Series Study ◽  
Quality Of Movement ◽  
Pre Treatment

Objective: To assess the functionality of the affected upper limb in children diagnosed with hemiplegia aged between 4 and 8 years after applying low-intensity modified Constraint-Induced Movement Therapy (mCIMT). Methods: Prospective case series study. A mCIMT protocol was applied for five weeks, with two hours of containment per day. The study variables were quality of movement of the upper limb, spontaneous use, participation of the affected upper limb in activities of daily living, dynamic joint position, grasp–release action, grasp strength, supination and extension elbow movements. Four measurements were performed, using the quality of upper extremity test (QUEST) scale, the Shriners Hospital for Children Upper Extremity Evaluation (SHUEE) Evaluation, a hand dynamometer and a goniometer. Results: The sample was composed of eight children with moderate manual ability. Statistically significant differences were detected in all the studied variables (p < 0.05) between the pre-treatment and post–treatment results (Week 0–Week 5), except for upper limb dressing, putting on splints and buttoning up. In the first week, the changes were statistically significant, except for protective extension, grasp strength, grasp–release and all functional variables (level of functionality and participation of the patient’s upper limbs) in the SHUEE Evaluation (p > 0.05). The greatest increase occurred in spontaneous use from Assessment 1 to Assessment 4 (p = 0.01), reaching 88.87% active participation in bimanual tasks. The quality of movement of the upper limb exhibited a significant value due to the increase in dissociated movements and grasp (p = 0.01). Conclusion: A low dose (50 h) of mCIMT increased the functionality of children diagnosed with congenital hemiplegia between 4 and 8 years of age with moderate manual ability.

scholarly journals Supernumerary Robotic Fingers: An Alternative Upper-Limb Prosthesis

2014 ◽  
Author(s):  
Faye Wu ◽  
Harry Asada
Keyword(s):  
Upper Limb ◽  
Work Load ◽  
Least Squares Regression ◽  
Prosthetic Devices ◽  
New Class ◽  
Upper Limb Prosthesis ◽  
Upper Limb Prostheses ◽  
Alternative Approach ◽  
New Type ◽  
Task Conditions

Conventional prosthetic devices substitute lost human limbs with mechanical proxies to enable amputees perform daily chores. We present an alternative approach that may replace or supplement traditional upper-limb prostheses by utilizing and enhancing the functionality of the remaining healthy limb with a new type of wrist-mounted robot: the Supernumerary Robotic (SR) Fingers. These SR Fingers are naturally and implicitly coordinated with the motion of the human fingers to provide assistance in a variety of prehensile tasks that are usually too difficult to carry out with a single hand, such as grasping a large/oddly shaped object or taking the lid off a jar. A novel control algorithm, termed “Bio-Artificial Synergies”, is developed so the SR Fingers can share a work load and adapt to diverse task conditions just like the real fingers do. Through grasp experiments and data analysis, postural synergies were found for a seven-fingered hand comprised of two SR Fingers and five human fingers. The synergy-based control law was then extracted from the experimental data using Partial Least Squares Regression (PLSR) and tested on the SR Finger prototype on a number of common tasks to demonstrate the usefulness and effectiveness of this new class of prosthetic device.

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