Carey Stephanie L, Lura Derek J, Highsmith M Jason
Department of Mechanical Engineering, University of South Florida, Tampa, FL;
J Rehabil Res Dev. 2015;52(3):247-62. doi: 10.1682/JRRD.2014.08.0192.
The choice of a myoelectric or body-powered upper-limb prosthesis can be determined using factors including control, function, feedback, cosmesis, and rejection. Although body-powered and myoelectric control strategies offer unique functions, many prosthesis users must choose one. A systematic review was conducted to determine differences between myoelectric and body-powered prostheses to inform evidence-based clinical practice regarding prescription of these devices and training of users. A search of 9 databases identified 462 unique publications. Ultimately, 31 of them were included and 11 empirical evidence statements were developed. Conflicting evidence has been found in terms of the relative functional performance of body-powered and myoelectric prostheses. Body-powered prostheses have been shown to have advantages in durability, training time, frequency of adjustment, maintenance, and feedback; however, they could still benefit from improvements of control. Myoelectric prostheses have been shown to improve cosmesis and phantom-limb pain and are more accepted for light=intensity work. Currently, evidence is insufficient to conclude that either system provides a significant general advantage. Prosthetic selection should be based on a patient's individual needs and include personal preferences, prosthetic experience, and functional needs. This work demonstrates that there is a lack of empirical evidence regarding functional differences in upper-limb prostheses.
可以通过包括控制、功能、反馈、美观和排斥等因素来确定选择肌电或体动式上肢假肢。尽管体动式和肌电控制策略具有独特功能,但许多假肢使用者必须选择其一。开展了一项系统评价,以确定肌电假肢和体动式假肢之间的差异,为关于这些装置的处方及使用者培训的循证临床实践提供依据。对9个数据库进行检索后识别出462篇独特的出版物。最终纳入了其中31篇,并制定了11条实证证据声明。在体动式假肢和肌电假肢的相对功能表现方面发现了相互矛盾的证据。体动式假肢在耐用性、训练时间、调整频率、维护和反馈方面已显示出优势;然而,它们在控制方面仍可受益于改进。肌电假肢已显示出可改善美观和幻肢痛,并且更适用于轻度工作。目前,尚无足够证据得出任一系统具有显著总体优势的结论。假肢的选择应基于患者的个人需求,包括个人偏好、假肢使用经验和功能需求。这项工作表明,关于上肢假肢功能差异缺乏实证证据。