Performance comparison among children fitted with myoelectric and body-powered hands
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1Prosthetics and Orthotics, New York University Post-Graduate Medical School, New York.
Insights
Children with below-elbow amputation showed similar performance with myoelectric (MYO) and body-powered (BP) prosthetic hands. While MYO hands led to more errors, neither prosthetic type significantly outperformed the other in most tasks.
Area of Science:
- Pediatric Rehabilitation
- Prosthetics and Orthotics
- Biomedical Engineering
Background:
- Unilateral below-elbow amputation affects children's functional abilities.
- Comparing myoelectric (MYO) and body-powered (BP) prosthetic hands is crucial for optimizing prosthetic selection.
- Understanding performance differences aids in clinical decision-making for pediatric prosthetic users.
Purpose of the Study:
- To compare the functional performance of myoelectric and body-powered prosthetic hands in children with unilateral below-elbow amputation.
- To evaluate task-specific efficiency and error rates between MYO and BP prosthetic hands.
- To assess overall user experience and quality of performance with different prosthetic technologies.
Main Methods:
- Seventy-six children (ages 6-17) with below-elbow amputation were randomly fitted with MYO and BP prosthetic hands.
- Each child used each prosthetic type for three months after initial training.
- Performance was assessed using a form board test and a battery of ten practical bimanual activities.
Main Results:
- Children using MYO prosthetics took 13.7% longer on the form board test and made more errors, including dropping objects.
- Object displacement errors were similar between MYO and BP hands.
- MYO hands were minimally faster in overall practical activities, but BP hands were significantly faster for card playing; MYO hands were faster for donning socks, cutting paper, and bandage application.
Conclusions:
- No major clinically significant differences in performance were observed between MYO and BP prosthetic hands in this pediatric cohort.
- Both prosthetic types demonstrated performance rated as poorer than normal quality.
- The choice between MYO and BP prosthetics may depend on specific task demands and individual user needs.
Abstract:
Seventy-six children with unilateral below-elbow amputation were fitted in random sequence with a myoelectric (MYO) and a body-powered (BP) prosthetic hand of identical size, shape, and glove color. Subjects ranged from six to 17 years, nine months and included 67 children with congenital limb deficiency and nine who sustained traumatic amputation. After training, each child wore each hand for three months. On the form board test requiring only prosthetic use, subjects took 13.7% longer with the MYO and committed more errors with the MYO, specifically in dropping objects and delaying their grasp and release. Object displacement, the most common error, occurred nearly as often with BP as MYO. MYO was minimally faster on a test of ten practical activities designed for bimanual prehension. Card playing was 39.8% faster with BP, whereas donning socks, cutting paper, and bandage application were 27.8%, 12.5%, and 10.9% faster with MYO. Performance with both hands was rated as decidedly poorer than normal quality. No major clinically important differences were found in the comparison of performance.