Authors: (including presenting author): :
LAM WT(1), Chan MKL(1), Wong KF(2), MA WL(1)
Affiliation: :
(1) Community Rehabilitation Service Support Centre, Queen Elizabeth Hospital, (2) Prosthetic and Orthotic Department, Kowloon Hospital
Keyword 1: :
upper limb amputation
Keyword 2: :
myoelectric hand
Keyword 3: :
rehabilitation
Introduction: :
Upper limb amputations are significant challenges for individuals, leading to serious functional and vocational impacts. Results In 2017, 57.7 million people were living with limb amputation due to traumatic causes worldwide.(1) Unlike lower limb amputations, upper extremity amputations are less common, affecting roughly 2-4 million people globally, which accounts for about 3-5% of the total amputee population. The causes of limb loss differ substantially. In adults, trauma is the leading cause of upper limb amputation, followed by cancer as the second most prevalent reason. Other contributing factors include infections, burns, and congenital deformities. This variation in causes highlights the multifaceted nature of limb loss and the importance of addressing the specific needs of those affected. Myoelectric hands represent a promising solution for individuals with upper limb amputations. However, their high cost often poses a significant barrier, discouraging patients from trying them due to concerns about affordability. With the introduction of new models at competitive prices, these advanced prosthetics could become more accessible, significantly increasing the likelihood of adoption in home and community settings. This affordability may empower more individuals to explore the benefits of myoelectric technology, enhancing their independence and quality of life.
Objectives: :
To investigate the feasibility of using myoelectric hand in community and client's home.
Methodology: :
A 33-year-old woman had an above-elbow amputation of her left arm in 2023 due to necrotizing fasciitis. Subsequently, she was referred to the CRSSC by the KH P&O department to trial a myoelectric hand. As part of her rehabilitation, the Centre P&O, along with an occupational therapist, conducted a thorough assessment and collaborated with her to establish specific goals. She identified four main objectives for using the myoelectric hand. First, she desires a lightweight design to facilitate easier control and enable her to put on and remove the device independently. Moreover, she aims to use her left hand for stabilizing a bottle while opening its cap and holding her mobile phone for app usage and internet searching. Lastly, she hopes to utilize the hand for lifting and managing bilateral tasks, such as cutting meat in the kitchen. Through these goals, she seeks to enhance her independence and improve her daily functioning.
Result & Outcome: :
The Centre P&O dedicated sessions to scan the stump, design the above-elbow (AE) socket using 3D printing technology, and fit it for the client. During this process, he also taught her how to don and doff the myoelectric hand independently. After few additional training sessions, she successfully learned to operate the myoelectric hand and execute six different movements. Once the client had acquired the basic operational skills, the Centre's occupational therapist assessed her performance in managing various tasks. Initially, adaptations were made, such as selecting appropriately sized and weighted bottles to facilitate gripping. Eventually, the client was able to grip her own bottle without any modifications. She even performed simulated shopping while holding a 2-pound weight. However, she still required assistance with cutting tasks, as she expressed concerns about the myoelectric hand getting wet. The goal attainment scale T-score improved from 37.2 to 50, indicating progress in her abilities. Overall, she felt satisfied with the trial of the myoelectric hand, particularly when considering its price and effectiveness. This experience demonstrates the myoelectric hand’s potential for long-term use among individuals with above-elbow amputations.
