Assessment of the Control and Utility of Multigrip Prosthetic Hands
Abstract
While the use of an upper limb prosthesis is positively correlated with increased health-related quality of life, employment rates, and ability to accomplish activities of daily living, over a quarter of people with upper limb absence choose not to wear one, citing a lack of perceived comfort and function. Numerous approaches have been developed to address the lack of prosthetic function, including the addition of moveable fingers enabling multiple functional grips, such as pinching or pointing, compared to the standard open and close. These multi-grip prostheses have been on the market since 2007, and there are now numerous commercially available options. Users also have several different commercially available options for control mechanisms that enable them to change their grip. Unfortunately, no standardized outcome measures currently exist that quantify the ability to change grips. Measuring the efficacy and benefit of these devices through outcome measures is vital to ensure optimal device selection, track rehabilitative progress, and inform health care policy and device prescription. This is particularly urgent given the continued effort and investment towards identifying ways to improve the reliability and intuitiveness of grip selection through approaches that often involve surgical interventions. To address these important needs, this study will develop a novel functional assessment that specifically quantifies how well users can change hand grip while completing an everyday task of brewing a cup of coffee. Aim 1 will determine if the Coffee Task is valid and responsive to changes in training with a prosthesis and different approaches to controlling grip switching. This aim will use healthy individuals controlling a prosthetic emulator. Aim 2 will determine the feasibility and reliability of the Coffee Task in upper limb prosthesis users who use multi-grip prostheses in their daily lives. This assessment will play an integral role in determining the level of functional benefits users can expect from different commercial multi-grip prostheses and their controllers. Outcomes from this newly developed assessment can be used to better inform prosthesis users, prosthetists who prescribe these devices, and insurance companies that determine coverage. The proposed work is intended to benefit Service Members, Veterans, and/or other beneficiaries with upper limb loss. There were approximately 41,000 people in the U.S. living with major upper limb loss in 2005. There have also been an estimated 1,645 major limb amputations as a result of the U.S. military missions in Afghanistan, Iraq, and Syria since 2001. While any amputation can have a devastating effect on an individual’s quality of life, upper limb loss has been found to be considerably more life-altering than lower limb loss. The majority of individuals with traumatic upper limb loss are in their prime of life and otherwise healthy. Therefore, providing intuitive and reliable multi-grip prostheses has a potential to significantly improve the quality of life of individuals with upper limb loss and encourage successful reintegration into society. According to a recent national survey of Veterans, 11% of those who use a prosthesis are currently using a multi-grip prosthesis. While the benefits of these devices have been found in a few recent case studies, more research is needed to determine how easily and accurately the users can change the hand grips, and thus enhance function. Research is also needed to determine which hand designs and control approaches might provide the greatest benefit. To do this effectively, it is necessary that the field have a standard, valid assessment to use for comparison. The proposed work fills that important gap. Following the completion of the proposed study, researchers and clinicians will have access to a feasible and reliable standardized assessment that is able to capture changes in prosthesis users’ skill level in grip manipulation
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Jan 04, 2024
- Source ID
- HT94252310097
Entities
People
- Deanna H. Gates
Organizations
- United States Army
- University of Michigan