Centre Louis Pierquin, Institut Régional de Médecine Physique et de Réadaptation, UGECAM, Nancy, Nord-Est, France.
PLoS One. 2023 Feb 2;18(2):e0272855. doi: 10.1371/journal.pone.0272855. eCollection 2023.
The functionalities of myoelectric hooks, such as whether they allow wrist movements, as well as the volume and design of the devices, may impact how fitted transradial amputees use their upper limbs. The aim of the current study was to compare two prosthetic myoelectric hooks in terms of compensatory shoulder movements, functionality and user satisfaction. This monocentric, randomized, controlled, cross-over trial evaluated eight transradial amputees fitted with two prosthetic myoelectric hooks, the Greifer and the Axon-Hook, during two consecutive periods. At the end of each period, shoulder abduction (mean and percentage of time with shoulder abduction > 60°) and manual dexterity were assessed using the Box and Blocks Test (BBT) on both sides, and satisfaction was assessed with the Evaluation of Satisfaction with Assistive Technology questionnaire. For each patient, data obtained with the BBT on the amputated side were compared with those obtained on the non-amputated side. Shoulder abduction was significantly higher with the Greifer (60.9°± 20.3°, p = 0.03) than with the Axon-Hook (39.8°± 16.9°) and also than with the NA side (37.6 ± 19.4°, p = 0.02). Shoulder abduction on the NA side (37.6 ± 19.4°) was close to that of the Axon-Hook (39.8°± 16.9°). The percentage of time spent with shoulder abduction > 60° during the BBT was higher with the Greifer than with the Axon-Hook or with the NA side (53.3 ± 34.4%, 17.6 ± 27.0% and 18.4 ± 34.9%, respectively), but the differences were not significant (p = 0.15). A significant strong negative correlation was found between shoulder abduction and wrist position with the Axon-Hook (r = -0.86; p < 0.01), but not with the Greifer. Manual dexterity and satisfaction did not differ significantly between the two devices. These results revealed compensatory movements, such as shoulder abduction in transradial amputees equipped with hooks, themselves influenced by the prosthetic device settings.
肌电钩的功能，如是否允许手腕运动，以及设备的体积和设计，可能会影响经桡骨截肢者如何使用他们的上肢。本研究的目的是比较两种假肢肌电钩在代偿性肩部运动、功能和用户满意度方面的差异。这项单中心、随机、对照、交叉试验评估了 8 名经桡骨截肢者在两个连续阶段使用两种假肢肌电钩（Greifer 和 Axon-Hook）的情况。在每个阶段结束时，使用 Box 和 Blocks 测试（BBT）评估双侧肩部外展（平均和外展角度大于 60°的时间百分比）和手灵巧度，并使用辅助技术满意度评估问卷（Evaluation of Satisfaction with Assistive Technology questionnaire）评估满意度。对于每个患者，使用 BBT 在截肢侧获得的数据与非截肢侧获得的数据进行比较。与 Axon-Hook 相比，Greifer 的肩部外展角度更高（60.9°±20.3°，p=0.03），与非截肢侧（37.6±19.4°，p=0.02）也更高。非截肢侧（37.6±19.4°）的肩部外展接近 Axon-Hook（39.8°±16.9°）。在 BBT 中，肩部外展角度大于 60°的时间百分比在 Greifer 中高于 Axon-Hook 或非截肢侧（分别为 53.3±34.4%、17.6±27.0%和 18.4±34.9%），但差异无统计学意义（p=0.15）。在 Axon-Hook 中，发现肩部外展与腕部位置之间存在显著的强负相关（r=-0.86；p<0.01），但在 Greifer 中则不存在。两种设备之间的手灵巧度和满意度没有显著差异。这些结果表明，配备钩子的经桡骨截肢者会进行代偿性运动，如肩部外展，而这些运动本身会受到假肢设备设置的影响。
