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Della Bella G, Santecchia L, Luttazi P, Mariani G, Pochiero L, Lacopo A, Delia C, Tofani M. The Use of ABILHAND-Kids in Children with Unilateral Congenital Below-Elbow Deficiencies and Acquired Amputation: An Italian Cross-Sectional Study. CHILDREN (BASEL, SWITZERLAND) 2024; 11:988. [PMID: 39201924 PMCID: PMC11352249 DOI: 10.3390/children11080988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 07/29/2024] [Accepted: 08/09/2024] [Indexed: 09/03/2024]
Abstract
Congenital or acquired hand differences, including unilateral below-elbow deficiencies, present complex challenges in pediatric rehabilitation. Surgical management and prosthetic provision represent a big challenge to find a good balance for guaranteeing optimal hand function. There is no specific assessment tool for measuring these aspects in the Italian context. The present study investigates the psychometric properties of the ABILHAND-Kids in children with congenital unilateral below-elbow deficiencies and acquired amputation of the upper limb. We measure internal consistency using Cronbach coefficient alpha and the intraclass correlation coefficient (ICC) for measuring test-retest reliability. Differences in hand function in both children with acquired or congenital diseases were also investigated. Participants to the study were 107 (49 F and 58 M) children, with a mean (SD) age of 8.88 (4.25). For test retest reliability, conducted on a sub-sample of 58 children, the ICC was 0.92, while for internal consistency, the Cronbach coefficient alpha was 0.90. We did not find statistically significant differences in scoring (p = 0.33) in the use (mean 29.25 SD 6.58) or non-use of a prosthetic device (mean 30.74 SD 7.43), while statistically significant differences were found in hand function (p < 0.01) for children who had a congenital impairment (mean 31.87 SD 6.49) and children who had an acquired amputation (mean 27.77 SD 6.60). In conclusion, the ABILHAND-Kids showed good internal consistency and reliability and can capture differences in hand function in children with both congenital and acquired hand disorders.
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Affiliation(s)
- Gessica Della Bella
- Management and Diagnostic Innovations & Clinical Pathways Research Area, Neurorehabilitation and Adapted Physical Activity Day Hospital, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (G.D.B.); (P.L.); (G.M.); (L.P.); (A.L.); (C.D.)
| | - Luigino Santecchia
- Orthopedic Department, Hand Surgery and Orthoplastic Service, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy;
| | - Paola Luttazi
- Management and Diagnostic Innovations & Clinical Pathways Research Area, Neurorehabilitation and Adapted Physical Activity Day Hospital, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (G.D.B.); (P.L.); (G.M.); (L.P.); (A.L.); (C.D.)
| | - Giordana Mariani
- Management and Diagnostic Innovations & Clinical Pathways Research Area, Neurorehabilitation and Adapted Physical Activity Day Hospital, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (G.D.B.); (P.L.); (G.M.); (L.P.); (A.L.); (C.D.)
| | - Lorenzo Pochiero
- Management and Diagnostic Innovations & Clinical Pathways Research Area, Neurorehabilitation and Adapted Physical Activity Day Hospital, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (G.D.B.); (P.L.); (G.M.); (L.P.); (A.L.); (C.D.)
| | - Alessandra Lacopo
- Management and Diagnostic Innovations & Clinical Pathways Research Area, Neurorehabilitation and Adapted Physical Activity Day Hospital, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (G.D.B.); (P.L.); (G.M.); (L.P.); (A.L.); (C.D.)
| | - Caterina Delia
- Management and Diagnostic Innovations & Clinical Pathways Research Area, Neurorehabilitation and Adapted Physical Activity Day Hospital, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (G.D.B.); (P.L.); (G.M.); (L.P.); (A.L.); (C.D.)
| | - Marco Tofani
- Management and Diagnostic Innovations & Clinical Pathways Research Area, Professional Development, Continuous Education and Research Service, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
- Department of Life Sciences, Health and Allied Healthcare Professions, Link Campus University, Via del Casale di San Pio V, 44, 00165 Rome, Italy
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Medina-Coello P, Salvador-Domínguez B, Badesa FJ, Rodríguez Corral JM, Plastrotmann H, Morgado-Estévez A. Anthropomorphic Robotic Hand Prosthesis Developed for Children. Biomimetics (Basel) 2024; 9:401. [PMID: 39056842 PMCID: PMC11275007 DOI: 10.3390/biomimetics9070401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 06/21/2024] [Accepted: 06/29/2024] [Indexed: 07/28/2024] Open
Abstract
The use of both hands is a common practice in everyday life. The capacity to interact with the environment is largely dependent on the ability to use both hands. A thorough review of the current state of the art reveals that commercially available prosthetic hands designed for children are very different in functionality from those developed for adults, primarily due to prosthetic hands for adults featuring a greater number of actuated joints. Many times, patients stop using their prosthetic device because they feel that it does not fit well in terms of shape and size. With the idea of solving these problems, the design of HandBot-Kid has been developed with the anthropomorphic qualities of a child between the ages of eight and twelve in mind. Fitting the features of this age range, the robotic hand has a length of 16 cm, width of 7 cm, thickness of 3.6 cm, and weight of 328 g. The prosthesis is equipped with a total of fifteen degrees of freedom (DOF), with three DOFs allocated to each finger. The concept of design for manufacturing and assembly (DFMA) has been integrated into the development process, enabling the number of parts to be optimized in order to reduce the production time and cost. The utilization of 3D printing technology in conjunction with aluminum machining enabled the manufacturing process of the robotic hand prototype to be streamlined. The flexion-extension movement of each finger exhibits a trajectory that is highly similar to that of a real human finger. The four-bar mechanism integrated into the finger design achieves a mechanical advantage (MA) of 40.33% and a fingertip pressure force of 10.23 N. Finally, HandBot-Kid was subjected to a series of studies and taxonomical tests, including Cutkosky (16 points) and Kapandji (4 points) score tests, and the functional results were compared with some commercial solutions for children mentioned in the state of the art.
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Affiliation(s)
- Pablo Medina-Coello
- Applied Robotics Research Group (TEP-940), School of Engineering, University of Cadiz, 11519 Puerto Real, Spain; (B.S.-D.); (J.M.R.C.); (A.M.-E.)
| | - Blas Salvador-Domínguez
- Applied Robotics Research Group (TEP-940), School of Engineering, University of Cadiz, 11519 Puerto Real, Spain; (B.S.-D.); (J.M.R.C.); (A.M.-E.)
| | - Francisco J. Badesa
- Centre for Automation and Robotics (CAR) UPM-CSIC, Universidad Politecnica de Madrid (UPM), 28040 Madrid, Spain;
| | - José María Rodríguez Corral
- Applied Robotics Research Group (TEP-940), School of Engineering, University of Cadiz, 11519 Puerto Real, Spain; (B.S.-D.); (J.M.R.C.); (A.M.-E.)
| | - Henrik Plastrotmann
- Department of Electrical Engineering and Computer Science, University of Applied Science Münster, 48565 Steinfurt, Germany;
| | - Arturo Morgado-Estévez
- Applied Robotics Research Group (TEP-940), School of Engineering, University of Cadiz, 11519 Puerto Real, Spain; (B.S.-D.); (J.M.R.C.); (A.M.-E.)
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Battraw MA, Fitzgerald J, James MA, Bagley AM, Joiner WM, Schofield JS. Understanding the capacity of children with congenital unilateral below-elbow deficiency to actuate their affected muscles. Sci Rep 2024; 14:4563. [PMID: 38402326 PMCID: PMC10894282 DOI: 10.1038/s41598-024-54952-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 02/19/2024] [Indexed: 02/26/2024] Open
Abstract
In recent years, commercially available dexterous upper limb prostheses for children have begun to emerge. These devices derive control signals from surface electromyography (measure of affected muscle electrical activity, sEMG) to drive a variety of grasping motions. However, the ability for children with congenital upper limb deficiency to actuate their affected muscles to achieve naturalistic prosthetic control is not well understood, as compared to adults or children with acquired hand loss. To address this gap, we collected sEMG data from 9 congenital one-handed participants ages 8-20 years as they envisioned and attempted to perform 10 different movements with their missing hands. Seven sEMG electrodes were adhered circumferentially around the participant's affected and unaffected limbs and participants mirrored the attempted missing hand motions with their intact side. To analyze the collected sEMG data, we used time and frequency domain analyses. We found that for the majority of participants, attempted hand movements produced detectable and consistent muscle activity, and the capacity to achieve this was not dissimilar across the affected and unaffected sides. These data suggest that children with congenital hand absence retain a degree of control over their affected muscles, which has important implications for translating and refining advanced prosthetic control technologies for children.
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Affiliation(s)
- Marcus A Battraw
- Department of Mechanical and Aerospace Engineering, University of California, Davis, Davis, CA, USA
| | - Justin Fitzgerald
- Department of Biomedical Engineering, University of California, Davis, Davis, CA, USA
- Department of Neurobiology, Physiology and Behavior, University of California, Davis, Davis, CA, USA
- Clinical and Translational Science Center, University of California, Davis Health, Sacramento, CA, USA
| | - Michelle A James
- Shriners Children's - Northern California, Sacramento, CA, USA
- Department of Orthopaedic Surgery, University of California, Davis Health, Sacramento, CA, USA
| | - Anita M Bagley
- Shriners Children's - Northern California, Sacramento, CA, USA
- Department of Orthopaedic Surgery, University of California, Davis Health, Sacramento, CA, USA
| | - Wilsaan M Joiner
- Department of Neurobiology, Physiology and Behavior, University of California, Davis, Davis, CA, USA
- Department of Neurology, University of California, Davis Health, Sacramento, CA, USA
| | - Jonathon S Schofield
- Department of Mechanical and Aerospace Engineering, University of California, Davis, Davis, CA, USA.
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Battraw MA, Young PR, Joiner WM, Schofield JS. A multiarticulate pediatric prosthetic hand for clinical and research applications. Front Robot AI 2022; 9:1000159. [PMID: 36388251 PMCID: PMC9651148 DOI: 10.3389/frobt.2022.1000159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 10/12/2022] [Indexed: 09/22/2024] Open
Abstract
Although beginning to emerge, multiarticulate upper limb prostheses for children remain sparse despite the continued advancement of mechatronic technologies that have benefited adults with upper limb amputations. Upper limb prosthesis research is primarily focused on adults, even though rates of pediatric prosthetic abandonment far surpass those seen in adults. The implicit goal of a prosthesis is to provide effective functionality while promoting healthy social interaction. Yet most current pediatric devices offer a single degree of freedom open/close grasping function, a stark departure from the multiple grasp configurations provided in advanced adult devices. Although comparable child-sized devices are on the clinical horizon, understanding how to effectively translate these technologies to the pediatric population is vital. This includes exploring grasping movements that may provide the most functional benefits and techniques to control the newly available dexterity. Currently, no dexterous pediatric research platforms exist that offer open access to hardware and programming to facilitate the investigation and provision of multi-grasp function. Our objective was to deliver a child-sized multi-grasp prosthesis that may serve as a robust research platform. In anticipation of an open-source release, we performed a comprehensive set of benchtop and functional tests with common household objects to quantify the performance of our device. This work discusses and evaluates our pediatric-sized multiarticulate prosthetic hand that provides 6 degrees of actuation, weighs 177 g and was designed specifically for ease of implementation in a research or clinical-research setting. Through the benchtop and validated functional tests, the pediatric hand produced grasping forces ranging from 0.424-7.216 N and was found to be comparable to the functional capabilities of similar adult devices. As mechatronic technologies advance and multiarticulate prostheses continue to evolve, translating many of these emerging technologies may help provide children with more useful and functional prosthesis options. Effective translation will inevitably require a solid scientific foundation to inform how best to prescribe advanced prosthetic devices and control systems for children. This work begins addressing these current gaps by providing a much-needed research platform with supporting data to facilitate its use in laboratory and clinical research settings.
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Affiliation(s)
- Marcus A. Battraw
- Department of Mechanical and Aerospace Engineering, University of California, Davis, Davis, CA, United States
| | - Peyton R. Young
- Department of Mechanical and Aerospace Engineering, University of California, Davis, Davis, CA, United States
| | - Wilsaan M. Joiner
- Departments of Neurobiology, Physiology and Behavior, University of California, Davis, Davis, CA, United States
- Department of Neurology, University of California, Davis, Davis, CA, United States
| | - Jonathon S. Schofield
- Department of Mechanical and Aerospace Engineering, University of California, Davis, Davis, CA, United States
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