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Gül H, Demirdel S, Yıldırım Şahan T, Anaforoğlu Külünkoğlu B, Baş SS, Çerezci Duygu S, Çınar MA, Keklicek H, Bayramlar K. A content comparison of 4 commonly used adult upper limb amputee outcome measurements with application of the refinements of International Classification of Functioning, Disability, and Health linking rules. Prosthet Orthot Int 2024; 48:448-454. [PMID: 37708333 DOI: 10.1097/pxr.0000000000000283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 07/20/2023] [Indexed: 09/16/2023]
Abstract
INTRODUCTION The application of the refinements of linking rules to the outcome measurement methods provides an opportunity to obtain information concerning what the available instruments actually measure and how the instrument measures certain outcomes. The purpose of the study was to analyze the content of 4 commonly used upper limb amputee scales using the refined International Classification of Functioning, Disability, and Health (ICF) linking rules. METHODS The Upper Extremity Functional Status module of the Orthotics and Prosthetics User Survey (OPUS-UEFS), Trinity Amputation and Prosthesis Experience Scales, Southampton Hand Assessment Procedure (SHAP), and Quick Disability of the Arm, Shoulder, and Hand were analyzed by 2 health professionals for a content comparison based on ICF categories. The Kappa statistic was used to calculate the degree of agreement between 2 professionals. RESULTS The scale questions were linked with 43 different ICF codes in this study. Trinity Amputation and Prosthesis Experience Scale addresses all ICF domains. All items of SHAP and most items of OPUS-UEFS were linked to the activity-participation domain. Quick Disability of the Arm, Shoulder, and Hand items were linked with activity-participation and body function domains. The perspectives of OPUS-UEFS and SHAP are descriptive. The perspectives of Quick Disability of the Arm, Shoulder, and Hand were descriptive and appraisal. The perspectives of Trinity Amputation and Prosthesis Experience Scale subscales were descriptive, appraisal, and needs or dependency. Estimated kappa values ranged from 0.44 to 0.91 for ICF codes. CONCLUSIONS Most concepts in the scales were frequently linked to the activity-participation domain. We think that the results of this study will be a useful guide to clinicians and researchers in selecting relevant and appropriate outcome measurements for upper limb amputee rehabilitation.
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Affiliation(s)
- Hatice Gül
- Vocational School of Health Services, Akdeniz University, Antalya, Türkiye
| | - Senem Demirdel
- Gülhane Faculty of Physiotherapy and Rehabilitation, University of Health Sciences, Ankara, Türkiye
| | - Tezel Yıldırım Şahan
- Gülhane Faculty of Physiotherapy and Rehabilitation, University of Health Sciences, Ankara, Türkiye
| | - Bahar Anaforoğlu Külünkoğlu
- Department of Physiotherapy and Rehabilitation, Faculty of Health Science, Ankara Yildirim Beyazit University, Ankara, Türkiye
| | - Sevilay Seda Baş
- Department of Physiotherapy and Rehabilitation, Faculty of Health Science, Ankara Yildirim Beyazit University, Ankara, Türkiye
| | - Senay Çerezci Duygu
- Department of Orthotics and Prosthetics, Gülhane Faculty of Health Sciences, University of Health Sciences, Ankara, Türkiye
| | - Murat Ali Çınar
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hasan Kalyoncu University, Gaziantep, Türkiye
| | - Hilal Keklicek
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Trakya University, Edirne, Türkiye
| | - Kezban Bayramlar
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hasan Kalyoncu University, Gaziantep, Türkiye
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Resnik L, Borgia M, Heinemann AW, Stevens P, Clark MA, Ni P. The Upper Extremity Functional Scale for Prosthesis Users (UEFS-P): subscales for one and two-handed tasks. Disabil Rehabil 2023; 45:3768-3778. [PMID: 36357971 DOI: 10.1080/09638288.2022.2138572] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 10/06/2022] [Accepted: 10/15/2022] [Indexed: 11/12/2022]
Abstract
PURPOSE To develop a self-report measure of activity performance for upper limb prosthesis users that quantifies outcomes by level of amputation and prosthesis type. MATERIALS AND METHODS Telephone survey of 423 adults with major upper limb amputation (ULA) who used a prosthesis. Item generation, cognitive, and pilot testing were followed by field testing. Items were categorized as one- or two-handed. Factor and Rasch analyses evaluated unidimensionality, monotonicity, item fit, differential item functioning (DIF), and reliability. Test-retest reliability was evaluated with intraclass correlation coefficients (ICCs). Known group validity was assessed with ANOVAs. RESULTS Respondents with unilateral ULA utilized prosthesis for 24% of unilateral and 38% of bilateral tasks. Those with bilateral ULA utilized prostheses for 64% of unilateral and 46% of bilateral tasks. Factor analyses identified a One-handed Task factor (CFI = 0.963, TLI = 0.950, and RMSEA = 0.064) and a Two-Handed Task factor (CFI = 0.958, TLI = 0.953, and RMSEA = 0.053). Response categories were collapsed to address monotonicity. After DIF adjustment, person reliability was 0.49 and 0.82 for One-handed and Two-handed Task scales, respectively, and ICCs were 0.88 and 0.91. Both scales differed by amputation level (p < 0.001). CONCLUSIONS The Upper Extremity Functional Scale for Prosthesis Users (UEFS-P) measure of upper limb function of prosthesis users has promising psychometric properties.Implications for rehabilitationMeasurement of upper limb function in persons with amputation is challenging, given currently available measures which do not explicitly grade activity performance with a prosthesis.The Upper Extremity Functional Scale for Prosthesis Users (UEFS-P) builds upon the original Orthotics and Prosthetics User Survey (OPUS) UEFS Scale with modified instructions, a revised item set, response categories and scoring algorithm.The UEFS-P consists of two unidimensional scales, the One-handed Tasks scale and the Two-handed Tasks scale.The UEFS-P scales have clear advantages over existing self-report measures of upper limb function that ask about difficulty with performing functional activities without accounting for prosthesis use, and do not differentiate persons who use and do not use a prosthesis.
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Affiliation(s)
- Linda Resnik
- Providence VA Medical Center, Providence, RI, USA
- Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, RI, USA
| | | | - Allen W Heinemann
- Shirley Ryan AbilityLab and Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Phillip Stevens
- Hanger Institute for Education and Clinical Research, Austin, TX, USA
- Division of PM&R, University of Utah Health, Salt Lake City, UT, USA
| | - Melissa A Clark
- School of Public Health, Brown University, Providence, RI, USA
| | - Pengsheng Ni
- Boston University School of Public Health, Boston, MA, USA
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Bochniewicz EM, Emmer G, Dromerick AW, Barth J, Lum PS. Measurement of Functional Use in Upper Extremity Prosthetic Devices Using Wearable Sensors and Machine Learning. SENSORS (BASEL, SWITZERLAND) 2023; 23:3111. [PMID: 36991822 PMCID: PMC10058354 DOI: 10.3390/s23063111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 03/11/2023] [Accepted: 03/12/2023] [Indexed: 06/19/2023]
Abstract
Trials for therapies after an upper limb amputation (ULA) require a focus on the real-world use of the upper limb prosthesis. In this paper, we extend a novel method for identifying upper extremity functional and nonfunctional use to a new patient population: upper limb amputees. We videotaped five amputees and 10 controls performing a series of minimally structured activities while wearing sensors on both wrists that measured linear acceleration and angular velocity. The video data was annotated to provide ground truth for annotating the sensor data. Two different analysis methods were used: one that used fixed-size data chunks to create features to train a Random Forest classifier and one that used variable-size data chunks. For the amputees, the fixed-size data chunk method yielded good results, with 82.7% median accuracy (range of 79.3-85.8) on the 10-fold cross-validation intra-subject test and 69.8% in the leave-one-out inter-subject test (range of 61.4-72.8). The variable-size data method did not improve classifier accuracy compared to the fixed-size method. Our method shows promise for inexpensive and objective quantification of functional upper extremity (UE) use in amputees and furthers the case for use of this method in assessing the impact of UE rehabilitative treatments.
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Affiliation(s)
- Elaine M. Bochniewicz
- The MITRE Corporation, McLean, VA 22102, USA
- Department of Biomedical Engineering, Catholic University of America, Washington, DC 20064, USA
| | - Geoff Emmer
- The MITRE Corporation, McLean, VA 22102, USA
| | - Alexander W. Dromerick
- Medstar National Rehabilitation Network, Washington, DC 20010, USA
- Veterans Affairs Medical Center, Providence, RI 02908, USA
- Department of Rehabilitation Medicine, Georgetown University, Washington, DC 20057, USA
| | - Jessica Barth
- Medstar National Rehabilitation Network, Washington, DC 20010, USA
- Veterans Affairs Medical Center, Providence, RI 02908, USA
| | - Peter S. Lum
- Department of Biomedical Engineering, Catholic University of America, Washington, DC 20064, USA
- Medstar National Rehabilitation Network, Washington, DC 20010, USA
- Veterans Affairs Medical Center, Providence, RI 02908, USA
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The multi-grip and standard myoelectric hand prosthesis compared: does the multi-grip hand live up to its promise? J Neuroeng Rehabil 2023; 20:22. [PMID: 36793049 PMCID: PMC9930076 DOI: 10.1186/s12984-023-01131-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 01/07/2023] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND Multi-grip myoelectric hand prostheses (MHPs), with five movable and jointed fingers, have been developed to increase functionality. However, literature comparing MHPs with standard myoelectric hand prostheses (SHPs) is limited and inconclusive. To establish whether MHPs increase functionality, we compared MHPs with SHPs on all categories of the International Classification of Functioning, Disability, and Health-model (ICF-model). METHODS MHP users (N = 14, 64.3% male, mean age = 48.6 years) performed physical measurements (i.e., Refined Clothespin Relocation Test (RCRT), Tray-test, Box and Blocks Test, Southampton Hand Assessment Procedure) with their MHP and an SHP to compare the joint angle coordination and functionality related to the ICF-categories 'Body Function' and 'Activities' (within-group comparisons). SHP users (N = 19, 68.4% male, mean age = 58.1 years) and MHP users completed questionnaires/scales (i.e., Orthotics and Prosthetics Users' Survey-The Upper Extremity Functional Status Survey /OPUS-UEFS, Trinity Amputation and Prosthesis Experience Scales for upper extremity/TAPES-Upper, Research and Development-36/RAND-36, EQ-5D-5L, visual analogue scale/VAS, the Dutch version of the Quebec User Evaluation of Satisfaction with assistive technology/D-Quest, patient-reported outcome measure to assess the preferred usage features of upper limb prostheses/PUF-ULP) to compare user experiences and quality of life in the ICF-categories 'Activities', 'Participation', and 'Environmental Factors' (between-group comparisons). RESULTS 'Body Function' and 'Activities': nearly all users of MHPs had similar joint angle coordination patterns with an MHP as when they used an SHP. The RCRT in the upward direction was performed slower in the MHP condition compared to the SHP condition. No other differences in functionality were found. 'Participation': MHP users had a lower EQ-5D-5L utility score; experienced more pain or limitations due to pain (i.e., measured with the RAND-36). 'Environmental Factors': MHPs scored better than SHPs on the VAS-item holding/shaking hands. The SHP scored better than the MHP on five VAS-items (i.e., noise, grip force, vulnerability, putting clothes on, physical effort to control) and the PUF-ULP. CONCLUSION MHPs did not show relevant differences in outcomes compared to SHPs on any of the ICF-categories. This underlines the importance of carefully considering whether the MHP is the most suitable option for an individual taking into account the additional costs of MHPs.
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Carlyle K, Day S. Outcome Measures Used to Assess Hand Activity in Amputee and Intact Populations: a Literature Review. CANADIAN PROSTHETICS & ORTHOTICS JOURNAL 2022; 5:39023. [PMID: 37614636 PMCID: PMC10443517 DOI: 10.33137/cpoj.v5i2.39023] [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: 07/22/2022] [Accepted: 12/12/2022] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The human hand is critical in assisting with activities of daily living (ADL). Amputation of the hand can affect a person physically, socially and psychologically. Knowledge of outcome measures used to assess upper limb activity of intact and amputee populations may aid in guiding research to develop applicable measurement tools specific to the amputee population. Tools could aid developments in prosthetic design and prescription, which benefit both users and healthcare researchers. OBJECTIVES This literature review examined outcome measurement tools used with non-amputee and amputee populations to assess hand activity. The objectives were to identify which characteristics of hand activity are captured by currently available measurement tools. METHODOLOGY Searches were conducted using PubMed, Cochrane and ProQuest for studies investigating hand activity for amputee and non-amputee populations. A total of 15 studies were included. PRISMA guidelines were used to assist with study selection. Data extraction and narrative synthesis were carried out. FINDINGS A total of 32 outcome measures were found. Frequently used tools were: Box and Block Test, Swedish Disabilities of the Arm Shoulder and Hand Questionnaire, and range of motion. Studies employed a combination of 2 to 12 tools. Themes extracted were: importance of function and quality of life, the need for realistic tasks, and the need for outcome measures specific of the population. CONCLUSION There is a gap in research surrounding outcome measurement tools used to assess hand activity in the amputee population. A combination of outcome measures are required to obtain insight into the hand activities of intact and amputee populations. Function and quality of life are important aspects to consider when describing hand activity.
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Affiliation(s)
- K Carlyle
- Department of Biomedical Engineering, Faculty of Engineering, University of Strathclyde, Glasgow, United Kingdom
- EPSRC Centre for Doctoral Training in Prosthetics and Orthotics, University of Salford, United Kingdom
| | - S Day
- Department of Biomedical Engineering, Faculty of Engineering, University of Strathclyde, Glasgow, United Kingdom
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Measurement Properties of the Patient-Specific Functional Scale and Its Current Uses: An Updated Systematic Review of 57 Studies Using COSMIN Guidelines. J Orthop Sports Phys Ther 2022; 52:262-275. [PMID: 35128944 DOI: 10.2519/jospt.2022.10727] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To systematically review measurement properties, including acceptability, feasibility, and interpretability, and current uses of the Patient-Specific Functional Scale (PSFS). DESIGN Systematic review of a patient-reported outcome measure using the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) guidelines. LITERATURE SEARCH We searched 11 databases from January 2010 to July 2020 for articles on measurement properties or use of PSFS. STUDY SELECTION CRITERIA Published primary articles without language restrictions. DATA SYNTHESIS Two independent reviewers screened all records, extracted data, and performed risk of bias assessments using COSMIN guidelines. We qualitatively synthesized findings for each measurement property in musculoskeletal and nonmusculoskeletal conditions, and 2 reviewers independently performed Grading of Recommendations Assessment, Development and Evaluation assessments. This study was preregistered with the Open Science Framework (https://doi.org/10.17605/OSF.IO/42UZT). RESULTS Of the 985 articles screened, we included 57 articles on measurement properties and 255 articles on the use of PSFS. The PSFS had sufficient test-retest reliability in musculoskeletal (22 studies, 845 participants, low-to-moderate certainty) and nonmusculoskeletal conditions (6 studies, 197 participants, very low certainty), insufficient construct validity as a measure of physical function (21 studies, 2 945 participants, low-to-moderate certainty), and sufficient responsiveness (32 studies, 13 770 participants, moderate-to-high certainty). The standard error of measurement ranged from 0.35 to 1.5. The PSFS was used in 87 unique health conditions, some without prior evidence of validity. CONCLUSION The PSFS is an easy-to-use, reliable, and responsive scale in numerous musculoskeletal conditions, but the construct validity of PSFS remains uncertain. Further study of the measurement properties of the PSFS in nonmusculoskeletal conditions is necessary before clinical use. J Orthop Sports Phys Ther 2022;52(5):262-275. Epub: 05 Feb 2022. doi:10.2519/jospt.2022.10727.
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Webster JB, Webster N, Borgia M, Resnik L. Frequency, severity, and implications of shoulder pain in people with major upper limb amputation who use prostheses: Results of a National Study. PM R 2021; 14:901-912. [PMID: 34219397 DOI: 10.1002/pmrj.12666] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 06/17/2021] [Accepted: 06/21/2021] [Indexed: 11/11/2022]
Abstract
BACKGROUND People with upper limb amputation are potentially at increased risk of shoulder pain because they often perform compensatory movements to operate their prostheses and rely more heavily on their nonamputated limb for everyday activities. OBJECTIVE To describe the frequency, severity, associated factors, and implications of shoulder pain in people with unilateral major upper limb amputation who use prostheses. DESIGN Cross-sectional, observational design. SETTING National recruitment of people living in the community. PARTICIPANTS U.S. veterans and civilians (N = 107) with unilateral major upper limb amputation. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Shoulder pain (any, ipsilateral and contralateral to amputation), activity performance (Activities Measure for Upper Limb Amputation), health-related quality of life (Veterans RAND 12-Item Health Survey mental component summary [MCS] and physical component summary [PCS]), and disability (Quick Version of the Disabilities of the Arm, Shoulder and Hand Score [QuickDASH]). RESULTS All participants completed a comprehensive in-person assessment. Participants were 97% male with a mean age of 57.1 years and a mean time since amputation of 23.4 years. The prevalence of any shoulder pain was 30% (15% ipsilateral, 25% contralateral, 10% bilateral). Shoulder pain intensity (0 to 10 scale) was moderate for both ipsilateral (mean 4.9, SD 2.0) and contralateral (mean 4.2, SD 2.0) pain. No significant difference in shoulder pain frequency was observed by amputation level. The prevalence of any shoulder pain was greater in those using a body-powered prosthesis (38% compared to 18% in externally powered users). Each additional year since amputation was associated with an increased likelihood of having contralateral shoulder pain (odds ratio: 1.05, confidence interval: 1.01, 1.10). In linear regression models, those with contralateral shoulder pain had worse PCS (β = -7.07, p = .008) and worse QuickDASH (β = 18.25, p < .001) scores. CONCLUSIONS In our sample of predominantly male veterans with major upper limb amputation, shoulder pain was a common condition associated with functional and quality of life implications. Among prosthesis users, the shoulder contralateral to the amputation was at greatest risk, with risk increasing with every year since amputation.
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Affiliation(s)
- Joseph B Webster
- Department of Physical Medicine and Rehabilitation, School of Medicine at Virginia Commonwealth University, Richmond, Virginia, USA.,Physical Medicine and Rehabilitation, Central Virginia VA Healthcare System, Richmond, Virginia, USA
| | | | - Matthew Borgia
- Research Department, Providence VA Medical Center, Providence, Rhode Island, USA
| | - Linda Resnik
- Research Department, Providence VA Medical Center, Providence, Rhode Island, USA.,Health Services, Policy and Practice, Brown University, Providence, Rhode Island, USA
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Fabbri B, Berardi A, Tofani M, Panuccio F, Ruotolo I, Sellitto G, Galeoto G. A systematic review of the psychometric properties of the Jebsen-Taylor Hand Function Test (JTHFT). HAND SURGERY & REHABILITATION 2021; 40:560-567. [PMID: 34023565 DOI: 10.1016/j.hansur.2021.05.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 05/02/2021] [Accepted: 05/13/2021] [Indexed: 10/21/2022]
Abstract
This systematic review of the literature aimed to identify studies examining the psychometric properties of the Jebsen-Taylor Hand Function Test (JTHFT) in various international populations on. The search was conducted in MEDLINE, SCOPUS, CINAHL and Web Of Science, with no restrictions on publication period, the country in which the study was conducted, or the age of the patients. Eligible studies were selected on the basis of inclusion criteria and data were extracted. Study quality and the risk of bias were assessed using the COnsensus-based Standards to select the health Measurement Instruments (COSMIN) checklist. 805 articles were identified; after removing duplicates, there were 361 single studies. 338 articles did not concern the psychometric properties of JTHFT. The remaining 23 studies were selected for full text review, and all were included. They comprised 8 languages and 9 pathologies. These findings suggest the JTHFT is a useful test of manual dexterity in activities of daily living. This study provides specific information on the instrument's psychometric properties in different populations and supports clinicians in making informed decisions when choosing instruments for upper-limb evaluations.
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Affiliation(s)
- B Fabbri
- Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy
| | - A Berardi
- Department of Human Neurosciences, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy
| | - M Tofani
- Department of Intensive Neurorehabilitation and Robotics, Bambino Gesù Children's Hospital, Piazza di Sant'Onofrio 4, 00165, Rome, Italy
| | - F Panuccio
- Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy
| | - I Ruotolo
- Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy
| | - G Sellitto
- Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy
| | - G Galeoto
- Department of Human Neurosciences, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185, Rome, Italy; IRCCS Neuromed, Via Atinense 18, 86077, Pozzili, Italy.
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Godfrey SB, Zhao KD, Theuer A, Catalano MG, Bianchi M, Breighner R, Bhaskaran D, Lennon R, Grioli G, Santello M, Bicchi A, Andrews K. The SoftHand Pro: Functional evaluation of a novel, flexible, and robust myoelectric prosthesis. PLoS One 2018; 13:e0205653. [PMID: 30321204 PMCID: PMC6188862 DOI: 10.1371/journal.pone.0205653] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 09/30/2018] [Indexed: 12/01/2022] Open
Abstract
Roughly one quarter of active upper limb prosthetic technology is rejected by the user, and user surveys have identified key areas requiring improvement: function, comfort, cost, durability, and appearance. Here we present the first systematic, clinical assessment of a novel prosthetic hand, the SoftHand Pro (SHP), in participants with transradial amputation and age-matched, limb-intact participants. The SHP is a robust and functional prosthetic hand that minimizes cost and weight using an underactuated design with a single motor. Participants with limb loss were evaluated on functional clinical measures before and after a 6-8 hour training period with the SHP as well as with their own prosthesis; limb-intact participants were tested only before and after SHP training. Participants with limb loss also evaluated their own prosthesis and the SHP (following training) using subjective questionnaires. Both objective and subjective results were positive and illuminated the strengths and weaknesses of the SHP. In particular, results pre-training show the SHP is easy to use, and significant improvement in the Activities Measure for Upper Limb Amputees in both groups following a 6-8 hour training highlights the ease of learning the unique features of the SHP (median improvement: 4.71 and 3.26 and p = 0.009 and 0.036 for limb loss and limb-intact groups, respectively). Further, we found no difference in performance compared to participant's own commercial devices in several clinical measures and found performance surpassing these devices on two functional tasks, buttoning a shirt and using a cell phone, suggesting a functional prosthetic design. Finally, improvements are needed in the SHP design and/or training in light of poor results in small object manipulation. Taken together, these results show the promise of the SHP, a flexible and adaptive prosthetic hand, and pave a path forward to ensuring higher functionality in future.
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Affiliation(s)
- Sasha Blue Godfrey
- Soft Robotics for Human Collaboration and Rehabilitation Lab, Department of Advanced Robotics, Istituto Italiano di Tecnologia, Genoa, GE, Italy
- Assistive and Restorative Technology Laboratory, Rehabilitation Medicine Research Center, Mayo Clinic, Rochester, MN, United States of America
| | - Kristin D. Zhao
- Assistive and Restorative Technology Laboratory, Rehabilitation Medicine Research Center, Mayo Clinic, Rochester, MN, United States of America
| | - Amanda Theuer
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, United States of America
| | - Manuel G. Catalano
- Soft Robotics for Human Collaboration and Rehabilitation Lab, Department of Advanced Robotics, Istituto Italiano di Tecnologia, Genoa, GE, Italy
- Assistive and Restorative Technology Laboratory, Rehabilitation Medicine Research Center, Mayo Clinic, Rochester, MN, United States of America
| | - Matteo Bianchi
- Assistive and Restorative Technology Laboratory, Rehabilitation Medicine Research Center, Mayo Clinic, Rochester, MN, United States of America
- Centro di Ricerca E. Piaggio, University of Pisa, Pisa, PI, Italy
| | - Ryan Breighner
- Assistive and Restorative Technology Laboratory, Rehabilitation Medicine Research Center, Mayo Clinic, Rochester, MN, United States of America
| | - Divya Bhaskaran
- Assistive and Restorative Technology Laboratory, Rehabilitation Medicine Research Center, Mayo Clinic, Rochester, MN, United States of America
| | - Ryan Lennon
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States of America
| | - Giorgio Grioli
- Soft Robotics for Human Collaboration and Rehabilitation Lab, Department of Advanced Robotics, Istituto Italiano di Tecnologia, Genoa, GE, Italy
| | - Marco Santello
- Neural Control of Movement Laboratory, School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ, United States of America
| | - Antonio Bicchi
- Soft Robotics for Human Collaboration and Rehabilitation Lab, Department of Advanced Robotics, Istituto Italiano di Tecnologia, Genoa, GE, Italy
- Centro di Ricerca E. Piaggio, University of Pisa, Pisa, PI, Italy
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ, United States of America
| | - Karen Andrews
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, United States of America
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Resnik LJ, Borgia ML, Acluche F, Cancio JM, Latlief G, Sasson N. How do the outcomes of the DEKA Arm compare to conventional prostheses? PLoS One 2018; 13:e0191326. [PMID: 29342217 PMCID: PMC5771605 DOI: 10.1371/journal.pone.0191326] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 01/03/2018] [Indexed: 12/13/2022] Open
Abstract
Objectives Objectives were to 1) compare self-reported function, dexterity, activity performance, quality of life and community integration of the DEKA Arm to conventional prostheses; and 2) examine differences in outcomes by conventional prosthesis type, terminal device type and by DEKA Arm configuration level. Methods This was a two-part study; Part A consisted of in-laboratory training. Part B consisted of home use. Study participants were 23 prosthesis users (mean age = 45 ± 16; 87% male) who completed Part A, and 15 (mean age = 45 ± 18; 87% male) who completed Parts A and B. Outcomes including self-report and performance measures, were collected at Baseline using participants’ personal prostheses and at the End of Parts A and B. Scores were compared using paired t-tests. Wilcoxon signed-rank tests were used to compare outcomes for the full sample, and for the sample stratified by device and terminal device type. Analysis of outcomes by configuration level was performed graphically. Results At the End of Part A activity performance using the DEKA Arm and conventional prosthesis was equivalent, but slower with the DEKA Arm. After Part B, performance using the DEKA Arm surpassed conventional prosthesis scores, and speed of activity completion was equivalent. Participants reported using the DEKA Arm to perform more activities, had less perceived disability, and less difficulty in activities at the End of A and B as compared to Baseline. No differences were observed in dexterity, prosthetic skill, spontaneity, pain, community integration or quality of life. Comparisons stratified by device type revealed similar patterns. Graphic comparisons revealed variations by configuration level. Conclusion Participants using the DEKA Arm had less perceived disability and more engagement of the prosthesis in everyday tasks, although activity performance was slower. After home use experience, activity performance was improved and activity speed equivalent to using conventional prostheses.
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Affiliation(s)
- Linda J. Resnik
- Research Department, Providence VA Medical Center, Providence, Rhode Island, United States of America
- Health Services, Policy and Practice, Brown University, Providence, Rhode Island, United States of America
- * E-mail:
| | - Matthew L. Borgia
- Research Department, Providence VA Medical Center, Providence, Rhode Island, United States of America
| | - Frantzy Acluche
- Research Department, Providence VA Medical Center, Providence, Rhode Island, United States of America
| | - Jill M. Cancio
- Center for the Intrepid, Brooke Army Medical Center JBSA, Ft. Sam Houston, TX, United States of America
- Extremtiy Trauma and Amputation Center of Excellence, Ft. Sam Houston, TX, United States of America
| | - Gail Latlief
- Department of PM&R, James A Haley Veteran’s Hospital, Tampa, FL, United States of America
| | - Nicole Sasson
- NYU School of Medicine, New York, New York, United States of America
- VA NY Health Harbor System, New York, New York, United States of America
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Julien M, D'Amours J, Leduc MP, Côté AC, Oziel Rodier R, Demers L, Desrosiers J. Responsiveness of the Box and Block Test with Older Adults in Rehabilitation. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2017. [DOI: 10.1080/02703181.2017.1356897] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Marjorie Julien
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Canada
| | - Justine D'Amours
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Canada
| | - Marie-Pier Leduc
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Canada
| | - Annie-Claude Côté
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Canada
| | - Rachel Oziel Rodier
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Canada
| | - Louise Demers
- School of Rehabilitation, Université de Montréal, Montreal, Quebec, Canada
| | - Johanne Desrosiers
- Universite de Sherbrooke Faculte de medecine et des sciences de la sante, Rehabilitation, North av, Sherbrooke, Quebec, Canada; Research Centre on Aging, Sherbrooke, Quebec, Canada
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12
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Resnik L, Borgia M, Silver B, Cancio J. Systematic Review of Measures of Impairment and Activity Limitation for Persons With Upper Limb Trauma and Amputation. Arch Phys Med Rehabil 2017; 98:1863-1892.e14. [DOI: 10.1016/j.apmr.2017.01.015] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 01/05/2017] [Accepted: 01/11/2017] [Indexed: 01/04/2023]
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Cross-Cultural Adaptation and Validation of the Jebsen-Taylor Hand Function Test in an Italian Population. Rehabil Res Pract 2016; 2016:8970917. [PMID: 27504203 PMCID: PMC4967698 DOI: 10.1155/2016/8970917] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 06/06/2016] [Accepted: 06/13/2016] [Indexed: 12/20/2022] Open
Abstract
Objective. This paper describes the Italian translation and adaptation to the Italian culture of the original version of the Jebsen-Taylor hand function test and conveys the procedure for testing its validity and reliability. Design. The cultural adaptation process and validation were based on data from a group of people with no clinical evidence of disease or impairment of the upper limbs. The process required a forward and reverse translation in its original language. The scale obtained was reviewed by 8 experts in the field of psychometrics dealing with statistical methods that are useful for the behavioral and social sciences. The Italian adapted version of the JTHFT was then produced and validated. Participants. The test was submitted to 320 people with no clinical evidence of disease in order to test its acceptability and consistency. Results. The total time required to perform each subtest was 80.16 ± 43.13 seconds for the nondominant hand (NDH) and 49.97 ± 27.28 seconds for the dominant hand (DH). The internal consistency (assessed with Pearson's r) and the reliability or the construct validity (assessed with Cronbach's alpha) are significative. Conclusions. This is the first study reporting the result of the translation, cultural adaptation, and validation protocols of the JTHFT in Italian. It provides a new tool for Italian professionals to measure the functionality of the hand in participants with various upper limb pathologies.
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Dimwamwa E, Johnson MJ. Kinematic analysis of unilateral and bilateral drinking task after brain and periphery injuries. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2015; 2015:4558-61. [PMID: 26737308 PMCID: PMC10998636 DOI: 10.1109/embc.2015.7319408] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
In this study, we aim to understand how functional movement is affected by various physical and neurological injuries. Using a novel system known as the Bilateral Assessment System (BiAS), we tracked the wrist movement of subjects with stroke, cerebral palsy, transradial amputations, as well as healthy individuals in space and in time as they completed a drinking task. The BiAS allowed us to analyze the kinematics of the movement of subjects to describe how specific impairment types at varying levels of the nervous system affect upper limb movement. Using kinematics to provide an objective analysis, the results suggest that bilateral ability is not analogous to unilateral ability and the importance of bilateral training, in addition to unilateral training, in the rehabilitation of injured persons is highlighted. In addition, motor, sensory, and strength impairment and subsequent ADL functional ability is a function of impairment level and not just impairment type.
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