Date Presented 3/31/2017
The purpose of this study was to examine the functionality of the biomechanical prosthetic finger. The researchers believe this study provides therapists with evidence to support using this prosthetic as an option for clients with digit amputations.
Primary Author and Speaker: Susan Denham
Additional Authors and Speakers: Taylor Hawkins, Kelsey Johnson, Jenna Rhoads, Sara Sims
PURPOSE: The purpose of this study was to examine the functionality of a recently developed body-powered prosthetic for digit amputations. The prosthetic is called the biomechanical prosthetic finger (BPF). Current prosthetic options for the upper extremity include passive, myoelectric, and body-powered devices. While there are many prosthetic options currently available for above-the-wrist amputations, there are few available options for partial hand and digit amputations, which are the most common amputations in the United States (Dillingham, Pezzin, & MacKenzie, 2002). Naked Prosthetics (Olympia, WA) recently produced the BPF to better serve those with partial hand and digit amputations. Unlike traditional options, the BPF is able to tolerate harsh conditions and does not require a harness. The creators of the BPF claim that it is able to reestablish function and mobility to individuals following a digit amputation by improving dynamic grasp patterns and manipulation skills.
To assess this claim, the researchers administered various standardized assessments (Minnesota Manual Dexterity Test, Jamar Hand Function Test, and Box and Blocks Test), a qualitative interview, and a functional outcomes measure (Disabilities of the Arm, Shoulder and Hand; DASH) to assess the participant’s function with and without the BPF. While completing this study, the researchers were unable to locate any other studies completed on this device.
DESIGN AND METHOD: This study is a single-subject descriptive case study. The participant was a 28-year-old man who currently wore two proximal interphalangeal–driven BPF devices. He was identified by a convenience sample obtained with assistance of the manufacturer. Data were collected over a 4-hr period in one session. The participant completed all standardized tests without the prosthetic and then completed the same tests with the prosthetics. The qualitative data were analyzed using descriptive statistics. A survey developed by the researchers and a functional outcome measure (DASH) were used to obtain qualitative data. Data were analyzed with thematic analysis.
RESULTS: The participant demonstrated improvements in all of the standardized assessments used in this study when wearing the BPF. In addition, he reported a higher level of efficacy during his personal and work activities when wearing the device. The results indicate that the participant objectively performed at a higher level of function while using the biomechanical prosthetic finger, and he indicated a higher level of satisfaction and efficacy while wearing the device.
CONCLUSION: The results of this study demonstrate objective and subjective improvements in hand function for the wearer of the BPF. The researchers believe this research will advance the practice and professional development of the participant and the field of occupational therapy by providing a baseline of information on a prosthetic that is new to the market. The researchers believe this study provides occupational therapists with evidence to support use of this prosthetic as an option for clients with digit amputations. This study is a sound basis for future research on this topic.
References
Carey, S. L., Lura, D. J., & Highsmith, M. J. (2015). Differences in myoelectric and body-powered upper-limb prosthesis: Systematic literature review. Journal of Rehabilitation Research and Development, 52, 247–262. https://doi.org/10.1682/JRRD.2014.08.0192
Dillingham, T., Pezzin, L., E., & MacKenzie, E. (2002). Limb amputation and limb deficiency: Epidemiology and recent trends in the United States. Southern Medical Journal, 95, 875–883.
Giladi, A. M., & Chung, K. C. (2014). Surgical principles and perspectives on upper extremity amputations. In M. C. Spires, B. M. Kelly, & A. J. Davis (Eds.), Prosthetic restoration and rehabilitation of the upper and lower extremity (pp. 127–140). New York: Demos Medical.
Jang, C. H., Yang, H. S., Yang, H. E., Lee, S. Y., Kwon, J. W., Yun, B. D., . . . Jeong, H. W. (2011). A survey on activities of daily living and occupations of upper extremity amputees. Annals of Rehabilitation Medicine, 35, 907–21. https://doi.org/10.5535/arm.2011.35.6.907
