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Fatigue-free operation of most body-powered prostheses not feasible for majority of users with trans-radial deficiency

HICHERT M; VARDY AN; PLETTENBURG D
PROSTHET ORTHOT INT , 2018, vol. 42, n° 1, p. 84-92
Doc n°: 187058
Localisation : Documentation IRR

D.O.I. : http://dx.doi.org/DOI:10.1177/0309364617708651
Descripteurs : EB22 - AVANT-BRAS / AMPUTATION DU MEMBRE SUPERIEUR

Body-powered prostheses require cable operation forces between 33 and
131 N. The accepted upper limit for fatigue-free long-duration operation is 20%
of a users' maximum cable operation force. However, no information is available
on users' maximum force. OBJECTIVES: To quantify users' maximum cable operation
force and to relate this to the fatigue-free force range for the use of
body-powered prostheses. STUDY DESIGN: Experimental trial. METHODS: In total, 23
subjects with trans-radial deficiencies used a bypass prosthesis to exert maximum
cable force three times during 3 s and reported discomfort or pain on a body map.
Additionally, subjects' anthropometric measures were taken to relate to maximum
force. RESULTS: Subjects generated forces ranging from 87 to 538 N. Of the 23
subjects, 12 generated insufficient maximum cable force to operate 8 of the 10
body-powered prostheses fatigue free. Discomfort or pain did not correlate with
the magnitude of maximum force achieved by the subjects. Nine subjects indicated
discomfort or pain. No relationships between anthropometry and maximal forces
were found except for maximum cable forces and the affected upper-arm
circumference for females. CONCLUSION: For a majority of subjects, the maximal
cable force was lower than acceptable for fatigue-free prosthesis use. Discomfort
or pain occurred in ~40% of the subjects, suggesting a suboptimal force
transmission mechanism. Clinical relevance The physical strength of users
determines whether a body-powered prosthesis is suitable for comfortable,
fatigue-free long-duration use on a daily basis. High cable operation forces can
provoke discomfort and pain for some users, mainly in the armpit. Prediction of
the users' strength by anthropometric measures might assist the choice of a
suitable prosthesis.

Langue : ANGLAIS

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