Novel golf prosthesis for bilateral upper limb loss: design, fabrication, and biomechanical evaluation

Individuals with bilateral upper limb loss face substantial barriers to independence and recreational participation. Adaptive sports can enhance psychological and physical well-being, yet few prosthetic devices are specifically designed or biomechanically evaluated for use in adaptive sports. Golf demands coordinated motion, stability, and dynamic control, often exceeding the capabilities of most traditional prostheses. Custom prosthetic solutions remain essential for enabling meaningful participation. This study aimed to design, fabricate, and evaluate a custom golf prosthesis for a veteran with bilateral upper limb loss, with primary emphasis on functional feasibility and characterization of swing biomechanics.

A custom carbon-fiber monolimb prosthesis with a hinged clamshell distal end was developed to secure the golf club. Following iterative fittings, biomechanical data were collected during driver swings to quantify body alignment, downswing kinematics, X-factor rotation, and weight shift relative to published normative datasets.

The custom prosthesis enabled independent club attachment, a coordinated two-armed golf swing, and participation in golf activities. Biomechanical analysis demonstrated reduced pelvis, torso, and lead arm angular velocities, diminished X-factor rotation, lower clubhead speed, and altered follow-through loading patterns relative to normative values.

The device demonstrated functional feasibility for adaptive golf participation in an individual with bilateral upper limb loss. This single-participant evaluation highlights important biomechanical considerations related to wrist orientation, load transfer, and stabilization in sport-specific prosthetic design. Findings support the role of user-centered, clinically feasible fabrication approaches in expanding access to adaptive sports while informing future biomechanical refinement and longitudinal outcome evaluation.