Background: An amputation of the upper extremity not only is devastating for the patient's physical, emotional, and social well-being but also constitutes a financial stress for both the patient and the health care system. The objective of this study was to determine the utility and quality-adjusted life-years of hand allotransplantation versus myoelectric prostheses and to compare these measures in patients afflicted with unilateral versus bilateral amputations.
Methods: A survey was administered on bilateral amputees, unilateral amputees, replantation patients, and healthy controls. Patient demographics, functional patient-reported outcomes, quality-of-life questionnaires, and utility outcome measures were calculated for four different scenarios: hand transplantation and myoelectric prostheses with or without complications.
Results: Five bilateral amputees, 12 unilateral amputees, nine replantation patients, and 45 healthy controls completed the survey. The highest quality-adjusted life-years were obtained in the replantation patient group for the scenario of myoelectric prosthesis without complications (mean, 34.8 years). Altogether, there was no statistically significant difference between hand transplantation and myoelectric prostheses (p = 0.36). On subgroup analysis, unilateral amputees reported significantly higher quality-adjusted life-years for myoelectric prostheses rather than hand transplantation (6.4; p = 0.0015), whereas bilateral amputees did not demonstrate a significant difference (-2.4; p = 0.299).
Conclusions: Utility and quality-adjusted life-years do not differ significantly between hand transplantation and myoelectric prostheses, except in unilateral amputees with myoelectric prostheses, who had higher quality-of-life scores. Based on trends from this pilot study, myoelectric prostheses may be considered for unilateral amputees, whereas no superiority can be demonstrated between both treatments in bilateral amputees.
Clinical Question/level Of Evidence: Therapeutic, III.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1097/PRS.0000000000008846 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Outdoor Overground Gait Biomechanics and Energetics in Individuals With Transtibial Amputation Walking With a Prescribed Passive Prosthesis and a Bionic Myoelectric Prosthesis.
J Appl Biomech
January 2025
J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA.
The metabolic cost of walking for individuals with transtibial amputation is generally greater compared with able-bodied individuals. One aim of powered prostheses is to reduce metabolic deficits by replicating biological ankle function. Individuals with transtibial amputation can activate their residual limb muscles to volitionally control bionic ankle prostheses for walking; however, it is unknown how myoelectric control performs outside the laboratory.
View Article and Find Full Text PDFHighly Responsive Robotic Prosthetic Hand Control Considering Electrodynamic Delay.
Sensors (Basel)
December 2024
Department of Robotics and Mechatronics, Tokyo Denki University, Tokyo 120-8551, Japan.
As robots become increasingly integrated into human society, the importance of human-machine interfaces continues to grow. This study proposes a faster and more accurate control system for myoelectric prostheses by considering the Electromechanical Delay (EMD), a key characteristic of Electromyography (EMG) signals. Previous studies have focused on systems designed for wrist movements without attempting implementation.
View Article and Find Full Text PDFOutcome measures used in the evaluation of adult upper-limb prostheses - kinematic and functional aspects: A scoping review.
Prosthet Orthot Int
January 2025
Department of Occupational Therapy, UFMG, Belo Horizonte, Minas Gerais, Brazil.
The abandonment rates of upper-limb (UL) prostheses are concerning and are related to limitations in the functional and kinematic aspects of the UL prosthesis. Evaluating the usability of prostheses is essential to make improvements in relation to these aspects and develop effective equipment and inform clinical results relevant to rehabilitation. The purpose of this scoping review is to explore the current state of the literature, the characteristics of studies on the topic, and the main parameters and instruments used to evaluate UL prosthesis, regarding kinematic and functional aspects.
View Article and Find Full Text PDFApplication of EMG feedback for hand prosthesis control in high-level amputation: a case study.
Sci Rep
December 2024
Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
EMG feedback improves force control of a myoelectric hand prosthesis by conveying the magnitude of the myoelectric signal back to the users via tactile stimulation. The present study aimed to test if this method can be used by a participant with a high-level amputation, and whose muscle used for prosthesis control (pectoralis major) was not intuitively related to hand function. Vibrotactile feedback was delivered to the participant's torso, while the control was tested using EMG from three different muscles.
View Article and Find Full Text PDFVirtual reality-based myoelectric prosthetic control training: Effects of action observation and motor imagery with visual feedback of electromyographic signals.
Prosthet Orthot Int
December 2024
Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan.
Background: Conventional myoelectric prostheses (myo-prostheses) training involves repetitive grasping and manipulation training, which requires considerable training time. It is necessary to develop a short and efficient myo-prostheses training. This study aimed to verify the immediate and sustained effects of action observation and motor imagery (AOMI) using virtual reality (VR) on myo-prostheses control and clarify the effect of visual feedback of electromyogram (EMG) signals during AOMI using VR.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!