This review presents an analytical and comparative survey of upper limb prosthesis acceptance and abandonment as documented over the past 25 years, detailing areas of consumer dissatisfaction and ongoing technological advancements. English-language articles were identified in a search of Ovid, PubMed, and ISI Web of Science (1980 until February 2006) for key words upper limb and prosthesis. Articles focused on upper limb prostheses and addressing: (i) Factors associated with abandonment; (ii) Rejection rates; (iii) Functional analyses and patterns of wear; and (iv) Consumer satisfaction, were extracted with the exclusion of those detailing tools for outcome measurement, case studies, and medical procedures. Approximately 200 articles were included in the review process with 40 providing rates of prosthesis rejection. Quantitative measures of population characteristics, study methodology, and prostheses in use were extracted from each article. Mean rejection rates of 45% and 35% were observed in the literature for body-powered and electric prostheses respectively in pediatric populations. Significantly lower rates of rejection for both body-powered (26%) and electric (23%) devices were observed in adult populations while the average incidence of non-wear was similar for pediatric (16%) and adult (20%) populations. Documented rates of rejection exhibit a wide range of variance, possibly due to the heterogeneous samples involved and methodological differences between studies. Future research should comprise of controlled, multifactor studies adopting standardized outcome measures in order to promote comprehensive understanding of the factors affecting prosthesis use and abandonment. An enhanced understanding of these factors is needed to optimize prescription practices, guide design efforts, and satiate demand for evidence-based measures of intervention.

https://journals.sagepub.com/doi/pdf/10.1080/03093640600994581

Upper limb prosthesis use and abandonment: A survey of the last 25 years:

Purpose. To measure consumer satisfaction with upper limb prosthetics and provide an enumerated list of design priorities for future developments.Methods. A self-administered, anonymous survey collected information on participant demographics, history of and goals for prosthesis use, satisfaction, and design priorities. The questionnaire was available online and in paper format and was distributed through healthcare providers, community support groups, and one prosthesis manufacturer; 242 participants of all ages and levels of upper limb absence completed the survey.Results. Rates of rejection for myoelectric hands, passive hands, and body-powered hooks were 39%, 53%, and 50%, respectively. Prosthesis wearers were generally satisfied with their devices while prosthesis rejecters were dissatisfied. Reduced prosthesis weight emerged as the highest priority design concern of consumers. Lower cost ranked within the top five design priorities for adult wearers of all device types. Life-like appearance is a pri...

Consumer design priorities for upper limb prosthetics

The loss of one hand can significantly affect the level of autonomy and the capability of performing daily living, working and social activities. The current prosthetic solutions contribute in a poor way to overcome these problems due to the limitations of the interfaces adopted for controlling the prosthesis and to the absence of force or tactile feedback which limit the hand grasp capabilities. In order to provide indications for further developments in the prosthetic field to increase user satisfaction rates and therefore to reduce device abandonment, this paper reports a literature review on needs analysis of upper limb prosthesis users, by pointing out the critical aspects of the prosthetic solutions in terms of users satisfaction and activities of daily living they would like to perform with the prosthetic device. A list of requirements for upper limb prostheses is proposed, grounded on the performed analysis on user needs. The defined list of requirements for the prosthetic system aims to provide (i) some guidelines for improving the level of acceptability and usefulness of the prosthesis, by accounting for hand functional and technical aspects; (ii) a possible functional scheme of a PNS-based prosthetic system able to satisfy the emerged user wishes; (iii) some hints for improving the quality of the methods (such as questionnaires) adopted for understanding the user satisfaction with their prosthesis.

/pdf/literature-review-on-needs-of-upper-limb-prosthesis-users-3m1xeug97m.pdf

Literature Review on Needs of Upper Limb Prosthesis Users.

https://eprints.soton.ac.uk/256475/1/science.pdf

Establishing a standardized clinical assessment tool of pathologic and prosthetic hand function: Normative data, reliability, and validity

Patterns of use of contemporary prostheses by 135 patients with major upper extremity amputations were evaluated by questionnaire. Eighty-four percent of the patients were male and 16% were female. Amputation levels represented were below elbow, 44%; above elbow, 40%; and shoulder disarticulations or forequarter amputations, 16%. The follow-up interval averaged 12 years (range, 1–67 years). One hundred and thirteen patients were fitted with either a myoelectric or body-powered prosthesis. The overall rejection rate was 38%. Thirty-nine of 42 in the below-elbow amputation group used the prosthesis and appeared to benefit the most. Eight of 141 in the wrist disarticulation group used the prosthesis: as did 9 of 21 in the above-elbow amputation group. In contrast, all bilateral amputees used their prostheses. Stiff shoulders and brachial plexus injury were both predictors for poor prosthetic usage.

Prosthetic usage in major upper extremity amputations

A postclinical investigation has been carried out among 42 unilateral amputees who lost their hand due to an accident. The investigation was directed at two main topics of interest. Firstly the amputee, the problems he has to cope with, and the role the prosthesis plays in his life; and secondly the prosthesis, its use and its potential benefits and burdens. The group of amputees consisted of above-elbow and belowelbow amputees. Body powered as well as myoelectric prostheses were represented in the group. Most of the information was obtained during a twoday home visit where a semi-structured interview was conducted, and where a number of daily life activities were observed. The information thus obtained has led to a number of conclusions and recommendations with respect to the rehabilitation of this category of amputees, and with respect to the design criteria of protheses for unilateral amputees.

/pdf/a-field-evaluation-of-arm-prostheses-for-unilateral-amputees-3c0hkd9ufm.pdf

M. J. Zuithoff

Papers

A field evaluation of arm prostheses for unilateral amputees