RESUMO
The DEKA Arm has multiple degrees of freedom which historically have been operated primarily by inertial measurement units (IMUs). However, the IMUs are not appropriate for all potential users; new control methods are needed. The purposes of this study were: 1) to describe usability and satisfaction of two controls methods-IMU and myoelectric pattern recognition (EMG-PR) controls-and 2) to compare ratings by control and amputation level. A total of 36 subjects with transradial (TR) or transhumeral (TH) amputation participated in the study. The subjects included 11 EMG-PR users (82% TR) and 25 IMU users (68% TR). The study consisted of in-laboratory training (Part A) and home use (Part B). The subjects were administered the Trinity Amputation and Prosthesis Experience satisfaction scale and other usability and satisfaction measures. Wilcoxon rank-sum tests compared the differences by control type. The differences were compared for those who did and did not want a DEKA Arm. The preferences for features of the DEKA Arm were compared by control type. The comparisons revealed poorer ratings of skill, comfort, and weight among EMG-PR users. The TR amputees using IMUs rated usability more favorably. TH amputees rated usability similarly. The TR amputees using EMG-PR were less satisfied with weight, pinch grip, and wrist display, whereas the TH amputees were less satisfied with the full system, wires/cables, and battery. Usability and satisfaction declined after Part B for EMG-PR users. Overall, we found that the IMU users rated the DEKA Arm and the controls more favorably than the EMG-PR users. The findings indicate that the EMG-PR system we tested was less well accepted than the IMUs for control of the DEKA Arm.
RESUMO
OBJECTIVE: (1) To identify outcome measures used in studies of persons with traumatic upper limb injury and/or amputation; and (2) to evaluate focus, content, and psychometric properties of each measure. DATA SOURCES: Searches of PubMed and CINAHL for terms including upper extremity, function, activities of daily living, outcome assessment, amputation, and traumatic injuries. STUDY SELECTION: Included articles had a sample of ≥10 adults with limb trauma or amputation and were in English. Measures containing most items assessing impairment of body function or activity limitation were eligible. DATA EXTRACTION: There were 260 articles containing 55 measures that were included. Data on internal consistency; test-retest, interrater, and intrarater reliability; content, structural, construct, concurrent, and predictive validity; responsiveness; and floor/ceiling effects were extracted and confirmed by a second investigator. DATA SYNTHESIS: The mostly highly rated performance measures included 2 amputation-specific measures (Activities Measure for Upper Limb Amputees and University of New Brunswick Test of Prosthetic Function skill and spontaneity subscales) and 2 non-amputation-specific measures (Box and Block Test and modified Jebsen-Taylor Hand Function Test light and heavy cans tests). Most highly rated self-report measures were Disabilities of the Arm, Shoulder and Hand; Patient Rated Wrist Evaluation; QuickDASH; Hand Assessment Tool; International Osteoporosis Foundation Quality of Life Questionnaire; and Patient Rated Wrist Evaluation functional recovery subscale. None were amputation specific. CONCLUSIONS: Few performance measures were recommended for patients with limb trauma and amputation. All top-rated self-report measures were suitable for use in both groups. These results will inform choice of outcome measures for these patients.
