A narrative review: current upper limb prosthetic options and design.

Purpose: This review was conducted to provide an overview of current literature as it relates to upper limb difference, available componentry, and prosthetic options and design. Emerging technologies combined with an increased awareness of the limb difference community have contributed to recent advancements in upper extremity prosthetics.Methods: A search of five major clinical databases utilizing keywords relating to upper limb prostheses, componenty and limb difference levels resulted in over 1200 articles. These articles were subjected to inclusion and exclusion criteria in order to identify current peer reviewed research relevant to this topic.Results: Fifty-five applicable articles and sources of standards were reviewed based on the inclusion and exclusion criteria, presenting five general options for prosthetic intervention. This information was assimilated and categorized in this article, which provides an overview of the aforementioned options.Conclusion: While a noteworthy amount of research focuses on technological advancements, the five options for prosthetic intervention are inherently represented in the current literature. For individuals with upper limb difference, as well as their care team, successful rehabilitation hinges on awareness of new components, the functional efficacy of these components, and the evolved techniques used in prosthetic design and fabrication. It is noted that the rapid evolution of upper limb prosthetics consistently outpaces research and publication of information.Implications for rehabilitationTo provide an overview of prosthetic design considerations and options to help create a more informed rehabilitation team, leading to improved outcomes in prescription and management of upper limb prosthetics.To bring awareness of current research in the field of upper limb prosthetics in order to provoke further exploration of the efficacy of prosthetic options and design considerations.

Capacity Assessment of Prosthetic Performance for the Upper Limb (CAPPFUL): Characterization of Normative Kinematics and Performance.

BACKGROUND: Evaluation of maladaptive compensatory movement is important to objectively identify the impact of prosthetic rehabilitative intervention on body mechanics. The Capacity Assessment of Prosthetic Performance for the Upper Limb (CAPPFUL) scores this type of compensation by comparing movements of the prosthesis user to movements of individuals with intact, sound upper limbs (ULs). However, expected movements of individuals with sound, intact ULs have not been studied for the set of tasks performed in the CAPPFUL. OBJECTIVE: To enhance the scoring approach for the maladaptive compensatory movement domain of the CAPPFUL by defining normative kinematic movement and characterizing variability and repeatability. DESIGN: Clinical measurement. SETTING: Laboratories at the U.S. Food and Drug Administration (FDA) and University of Texas-Arlington. PARTICIPANTS: Convenience sample of 20 participants with no upper limb (UL) disability or impairment. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASUREMENTS: Kinematic trajectories, range of motion, maximum angle, and completion time were calculated. Repeatability and intersubject variability were assessed by calculating Pearson's correlation coefficient (R), adjusted coefficient of multiple correlation (CMCadj), and max SD (SDmax) for nine joint angles at the elbow, shoulder, neck, and torso. RESULTS: For most joints evaluated, repeatability was lower (R < 0.8) for CAPPFUL 3-Zip vest, CAPPFUL 7-Cut w/ knife, and CAPPFUL 8-Squeeze water, implying inconsistent approaches within a subject from trial to trial for a given task. For most tasks, the joint angle SDmax across all participants was <20°. The approach for completing CAPPFUL 1 - Weights in crate and CAPPFUL 4 - Pick up dice was generally similar across participants (CMCadj >0.4). For other tasks, however, different approaches across participants at the torso and shoulder joint can be seen. CONCLUSION(S): This work established the expected movements of individuals with sound, intact ULs for tasks performed in the CAPPFUL that can be used to inform consistent, standardized scoring of the maladaptive compensatory movement domain.