Assessment of multigrip prosthetic hand by a crossover longitudinal study

Abstract

The major function of the hand that the upper limb prosthesis tries to replicate is grasp. New myoelectric devices with multiarticulated hands are available and are reimbursed by French health care system. These devices propose several types of grip, which are getting closer to human hand movements. Few studies evaluated the impact of these devices on prehensile function. It is important for the rehabilitation team to know how upper limb amputees manage these devices in their daily lives to improve rehabilitation. The aim of this study was to evaluate the functional use of these new myoelectric prosthetic hand (NMPH) compared to tridigital myoelectric hand (TDMH). Eight unilateral transradial upper limb amputees (7 male, 1 female, age 39.5 ± 14 years old) wearing usually a myoelectric prosthesis participated in this prospective crossover study. Functional assessment was realized by each participant with their own tridigital myoelectric prosthesis and a multigrip prosthesis after specific rehabilitation and one month of home use. Self-report questionnaires included Quick DASH, Orthotics and Prosthetics Users Survey (OPUS) and the French version of the Quebec Users Evaluation Satisfaction with Assistive Technology (QUEST). Clinical tests included Box and Blocks Test (BBT) in sitting position, Southampton Hand Assessment Procedure (SHAP) and the third phase of Hand 400 points. These values were compared for each participant between both myoelectric prosthesis. There is no significant difference between both devices for manual dexterity (BBT), gripping capabilities (SHAP) and grasping capabilities, as assessed by the third phase of Hand 400 points which also visually evaluates shoulder and trunk compensations during the movement of the objects, and technology satisfaction (QUEST). In this study, the use of these new multiarticulated prosthetic hands did not influence the gripping capabilities at 1 month of home use. In the literature, an increased manual dexterity was found at 3 months of home use (Luchetti et al., JRRD 2015). However, these new devices providing several types of grip, may be of interest in decreasing shoulder or trunk compensations during grasp in upper limb amputees. Further studies are mandatory to objectively evaluate these compensations using optoelectronic systems and could be used for assessment of rehabilitation programs.