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Updated: Feb 23, 2026
A Structured Rehabilitation Protocol for Improved Multifunctional Prosthetic Control: A Case Study
Published on: November 6, 2015
Long-term results of early myoelectric prosthesis fittings: A prospective case-control study
Lis Sjöberg1, Helen Lindner1, Liselotte Hermansson2,3
11 Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden.
Insights
Fitting children with myoelectric hand prostheses before 2½ years of age showed no long-term benefits. Early fitting did not improve prosthetic skill or use compared to later fitting, with higher rejection rates observed.
Area of Science:
- Pediatric rehabilitation
- Prosthetics and orthotics
- Biomedical engineering
Background:
- Optimal age for fitting myoelectric hand prostheses in children remains debated.
- Early intervention versus later fitting strategies require comparative analysis.
Purpose of the Study:
- To compare prosthetic skill, use, and rejection risk over time.
- To evaluate outcomes between children fitted before versus after 2½ years of age.
Main Methods:
- Prospective case-control study design.
- Inclusion of 9 early-fitted (before 2½ years) and 27 late-fitted (after 2½ years) children.
- Assessment of prosthetic skill (Skills Index Ranking Scale) and use (wearing time/pattern); survival analysis for rejection risk.
Main Results:
- Early-fitted children demonstrated initial prosthetic skill, but late-fitted children achieved comparable skill by 3½ years.
- A significant decrease in prosthetic use was noted in early-fitted children by age 9.
- Early fitting was associated with a higher long-term prosthesis rejection rate.
Conclusions:
- Fitting myoelectric hand prostheses before 2½ years offers no discernible advantages in skill or use over time.
- Later fitting appears to yield comparable or better long-term outcomes regarding prosthesis use and rejection.
- Clinical recommendations should consider these findings to optimize prosthetic fitting strategies for children.
Background:
Different recommendations exist regarding what age is best for first-time fitting of myoelectric hand prostheses in children.
Objectives:
To compare prosthetic skill, prosthetic use and risk for rejection over time between children fitted with myoelectric hand prostheses before or after 2½ years of age.
Study Design:
Prospective case-control design.
Methods:
The cases were nine children fitted with myoelectric hand prostheses before the age of 2½ years, whereas the controls were 27 children who were fitted with myoelectric hand prostheses after the age of 2½ years. The Skills Index Ranking Scale was used to classify prosthetic skill, and prosthetic use was categorised based on wearing time and pattern. Independent samples tests were used to compare data between groups. To estimate and compare the risk of prosthesis rejection between groups and over time, survival analysis was used.
Results:
Cases showed prosthetic skill early, but controls had caught up by the age of 3½ years. Cases had a significant ( p = 0.046) decrease in prosthetic use at the age of 9 years. In the long term, cases had a higher percentage of prosthesis rejection.
Conclusions:
Considering young children's development of prosthetic skill and prosthetic use over time, this study shows no additional advantages from fitting a myoelectric hand prosthesis before 2½ years of age. Clinical relevance Children may be fitted with myoelectric hand prostheses to assist in daily tasks and to prevent future over-use problems. Most children fitted with myoelectric hand prostheses before 4 years of age become regular users. No advantages of fitting myoelectric hand prostheses before 2½ years of age were observed.
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