• KARM
  • Contact us
  • E-Submission
ABOUT
ARTICLE TYPES
BROWSE ARTICLES
AUTHOR INFORMATION

Articles

Original Article

A Survey on Activities of Daily Living and Occupations of Upper Extremity Amputees

Chul Ho Jang, M.D., Hee Seung Yang, M.D., Hea Eun Yang, M.D., Seon Yeong Lee, M.D., Ji Won Kwon, M.D., Bong Duck Yun, C.P.O.1, Jae Yung Choi, M.D.2, Seon Nyeo Kim, M.D.3, Hae Won Jeong, M.D.4
Annals of Rehabilitation Medicine 2011;35(6):907-921.
Published online: December 30, 2011

Department of Rehabilitation Medicine, Seoul Veterans Hospital, Seoul 134-791, Korea.

1Center of Prosthetics and Orthotics, Seoul Veterans Hospital, Seoul 134-791, Korea.

2Department of Rehabilitation Medicine, Yeongju Municipal Hospital, Yeongju 750-871, Korea.

3Department of Rehabilitation Medicine, Bestone Geriatric Hospital, Yongin 446-908, Korea.

4Department of Rehabilitation Medicine, Gongju Health Center, Gongju 314-802, Korea.

Corresponding author: Hee Seung Yang. Department of Rehabilitation Medicine, Seoul Veterans Hospital, 6-2, Doonchun-dong, Kangdong-gu, Seoul 134-791, Korea. TEL: +82-2-2225-1498, FAX: +82-2-2225-1579, yang7310@naver.com
• Received: July 1, 2011   • Accepted: August 24, 2011

Copyright © 2011 by Korean Academy of Rehabilitation Medicine

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

  • 10,416 Views
  • 206 Download
  • 91 Crossref
prev next
  • Objective
    To assess prosthetic use by upper extremity amputees, and their difficulties with prostheses in activities of daily living and occupations.
  • Method
    This study is based on a survey of 307 subjects, who were using prostheses manufactured in the Center of Prosthetics and Orthotics. The survey questionnaire included items about general demographic characteristics, side and level of amputation, type of prosthesis and its use, and difficulties in the activities of daily living, employment and driving.
  • Results
    The most common type of prosthesis was the cosmetic hand type (80.2%). There were no statistically significant correlations between satisfaction with prosthesis and the amputation level or type of prosthesis. The most common difficulties in daily living activities experienced by amputees were lacing shoes, removing bottle-tops with a bottle opener, and using scissors. Only 7.3% of amputees received rehabilitation services. Less than half of the amputees (44.7%) used their prostheses for eight or more hours a day, and 76.9% used their prostheses for regular or irregular cosmetic purposes. After amputation, most of the respondents (69.0%) became unemployed or changed workplaces.
  • Conclusion
    In our study, respondents preferred cosmetic usage to functional usage. Only 30.0% of respondents reported satisfaction with their prostheses. Many of the amputees had difficulties in complex tasks and either changed jobs or became unemployed. Clerical workers were the occupation group, which was most likely to return to work. The development of a more functional prosthetic hand and additional rehabilitation services are required.
According to a study of the medical records of Korean amputees published in 1996 in Korea on the frequency of occurrence of amputation for each area of amputation, the ratio of upper extremity amputation to lower extremity amputation was approximately 1 : 2.2 with upper extremity amputation accounting for the relatively lower proportion.1 Since prosthetic limbs for the upper extremities have technical difficulties in reproducing delicate and complex movements and the tactile and proprioceptive sensory functions of the hand and upper extremities, upper extremity amputees experience an enormous sense of frustration and problems in the rehabilitation process.2 Although prosthetic limbs have been developed and recently used in combination with electronic technologies such as myoelectric prostheses, the prosthetic limbs themselves still remain heavy, fail to reproduce precision movement functions and have a slow movement speed. Clearly, there are continuing substantial problems in the prosthetic replacement of hands.3,4
In the case of those with unilateral upper limb amputation, unlike the lower limb amputees, a relatively large number of the amputees do not use their prosthetic limb because they can compensate adequately for the in conveniences in carrying out daily activities by use of their remaining upper limb. Moreover, the majority of amputees only use their prosthesis for cosmetic reasons. They have a low level of satisfaction with its functional use and are therefore poorly motivated and reluctant to use it for this purpose and undergo rehabilitation training.5
Accordingly, this study carried out a questionnaire survey of patients, who had been prescribed upper extremity prosthetic limbs by the Center of Prosthetics and Orthotics. The purpose of this survey was to assess the actual usage of a prosthetic limb by upper extremity amputees and to determine the impacts of its use on the performance of daily living activities and levels of satisfaction. Issues related to occupation and driving after injury were also explored. Our objective was to identify changes which might be occurring over time by comparing our results with those of previous studies. An additional purpose was to provide data, which can form the basis for helping in the future development of prosthetic limbs and the rehabilitation treatment of upper extremity amputees.
Subjects
A postal questionnaire survey was conducted with 968 amputees, who had received an upper extremity prosthetic device from the Center of Prosthetics and Orthotics in the Department of Rehabilitation Medicine at Seoul Veterans Hospital during the period January, 2000, to June, 2008. Questionnaires were returned by 344 amputees, but 37 were incomplete and excluded from the analysis. Additional exclusion criteria were cases with disabilities affecting the functioning of their lower extremityies, and those with nervous system lesions and diseases, which could affect activities of daily living or their occupation. There was no case in 307 amputees.
Composition of questionnaire
The content of the questionnaire (see Appendix) included items about the general characteristics of the respondents, questions about their prosthetic limbs, and issues related to activities of daily living, rehabilitation training, occupation and driving. More specifically, the information requested about general characteristic included gender, current age, age at the time of amputation, educational background, side of the dominant hand prior to amputation, and side and level of amputation. Questions about their prostheses included the type of prosthetic limb used most frequently, levels of satisfaction with their prosthetic limbs and the average duration of daily usage of the prosthetic limbs. Information was obtained about whether amputation was unilateral (right or left) or bilateral and about the levels of the amputation on the left and/or the right side. Pictures along with explanations were included in the questionnaire in order to assist the the respondents' understanding of the questions relating to levels of am putation and type of prosthetic limb used. If the responses to these questionnaire items were missing or inadequate, the relevant information was obtained from the medical records kept at the hospital as well as the records available at the Center of Prosthetics and Orthotics.
The respondents were asked whether they had received rehabilitation training after wearing their prosthetic limb and the perceived importance of the rehabilitation training. Questions were also asked about levels of satisfaction and the extent to which the amputees could perform daily living activities after receiving their prosthetic limb. A total of 17 examples of the daily living activities were included: washing face, combing hair, putting on and taking off underwear, buttoning shirts, closing zipper of pants, wearing socks, tying of shoes laces, eating with spoon, opening and drinking canned beverages, writing name with a pencil, using scissors, opening doors by turning door knobs, opening and drinking a bottled beverage using a bottle opener, making telephone calls by pressing buttons on a mobile phone, opening envelopes, putting on and taking off prosthesis without the help of another person and mixing of blackbean-sauce noodles. The questions asked whether it had been possible to perform the above tasks and, if so, the extent of the difficulties in carrying out such tasks. In reality, almost all the subjects, who said the task was possible, failed to indicate the extent of difficulty in carrying out the task. For the purpose of analysis, the subjects were therefore coded into two groups: capable and or incapable of conducting the task. For the 17 detailed items, reference was made to the list of activities associated with upper extremities used by Davidson,6 but these were modified to make them more representative of daily living in Korea. For the extent of return to their previous occupation after amputation, the amputees were asked about occupational changes and the issues, which were problematic in terms of returning to their initial occupation. For the question about whether the amputee currently has an occupation, subjects were given the opportunity to indicate whether they had ceased employment due to their age. The items related to driving inquired whether the amputee drove vehicles before and after amputation, whether the vehicle had been remodeled if amputee continued to drive, and the reasons for not driving if the amputee had ceased to drive after amputation. Finally, items were included, which related to the presence, extent and types of pain/discomfort at stump sites.
Statistical analysis
All analyses were performed with PASW Statistics 18, and statistical significance was set at p<0.05. General characteristics and issues related to prosthetic limbs were summarised with descriptive statistics and frequency counts. Pearson's chi-square test was used to analyse variables related to the usage of prosthetic limbs, rehabilitation training and driving. ANOVA and independent t-tests were conducted to examine differences in the variables related to activities of daily living and occupation.
Characteristics and clinical aspects of the subjects of the study
The results are summarized in Table 1. All of the 307 subjects were male and ranged in age from 27 to 88 years with a mean of 66.85 years. There were 95 subjects in their 70's (30.9%), 79 in their 60's (25.7%) and 59 in their 50's (19.2%). The mean age at the time of amputation was 25.70 years, and the mean time elapsing since the amputation was 40.15 years. In terms of educational background, 107 (34.9%) of the amputees were high school graduates. This was the largest group, followed by 84 (27.3%) with only elementary school education, 58 (18.9%) middle school graduates, and 58 (18.9%) with university or graduate school education. Among the total sample of amputees, 273 had anamputation only on one side of the body, while 34 had bilateral amputations. In the case of unilateral amputation, 150 (54.9%) subjects had damage on the dominant hand side.
Issues related to prosthetic limb
Among the 273 unilateral upper limb amputees, transradial amputation was the most frequent (n=132, 48.4%), followed by transhumeral amputation (n=53, 19.4%), partial hand and fingers amputation (n=49, 17.9%), shoulder disarticulation (n=18, 6.6%), wrist disarticulation (n=18, 6.6%) and elbow disarticulation (n=3, 1.1%) (Table 2). Among the unilateral upper limb amputees, the types of prosthetic limb currently used included cosmetic hands (n=219, 80.2%), functional hands (n=41, 15.0%), and hook hands (n=13, 4.8%). Only one amputee in the entire group surveyed (including the bilateral upper limb amputees) used a myoelectric prosthetic limb. Those with an amputation of the dominant hand were found to use functional and hook hands more frequently than those with an amputation of the non-dominant hand (p<0.05). In response to the question about the level of satisfaction with the prosthetic limb currently being used, largest number of subjects (n=113, 41.4%) reported it to be 'moderate'. The number of respondents, who reported being 'very satisfied' or 'somewhat satisfied' (n=82, 30.0%), was similar to the number, who were 'dissatisfied' (n=78, 28.6%). Differences in the degrees of satisfaction with prosthetic limbs according to the level of the amputation and type of prosthetic limb (Table 3) were not statistically significant. When the amputees were asked about the hours of daily use of their prostheses (Table 4), 122 (44.7%) subjects reported an average daily use of 8-16 hours, 64 (23.4%) answered 4-8 hours, and 37 (13.6%) used their prostheses for less than 4 hours. A group of 50 (18.3%) subjects indicated almost no use. There were no significant differences in the reported average duration of daily use of prosthetic limbs by level of amputation or by type of prosthetic limb.
Activities of daily living and rehabilitation training
While only 20 (7.3%) of the unilateral amputees reported receiving rehabilitation training after being given a prosthetic limb, 59 (21.6%) responded that they felt rehabilitation training is essential. Although the group who received rehabilitation training was more aware of the importance of rehabilitation training (p<0.001), there were no significant clinical differences between the groups who and had not felt the need for rehabilitation training. On the question of the extent of usage of a prosthetic limb for the upper extremity in activities of daily living (Table 5), 9 (3.3%) subjects responded that they were able to perform complicated tasks, including repairs in the house, 12 (4.4%) reported that they could hold and lift objects, 8 (2.9%) responded they could hold onto their surroundings to prevent falling, 119 (43.6%) indicated that used their prosthetic limbs all the time for cosmetic purposes, 91 (33.3%) responded that they wore their prosthetic limbs occasionally for cosmetic purposes when going out, and 34 (12.5%) stated that their prosthetic limbs did not provide any functional assistance. A total of 210 (76.9%) subjects responded that they used their prosthetic limbs all the time or occasionally for cosmetic purposes. The amputees using prostheses for cosmetic purposes were not statistically different from those using them for functional purposes in terms of the type of prosthesis, average duration of daily usage of prosthetic limb, or level of amputation, but they did report a lower level of satisfaction with their prosthetic limbs (p<0.05). On the question of level of satisfaction with activities of daily living which they performed without the help of others, 7 (2.6%) subjects were highly satisfied, 57 (20.9%) were somewhat satisfied, 121 (44.3%) moderate, 36 (13.2%) were somewhat dissatisfied, and 52 (19.0%) were highly dissatisfied. There were no significant differences in the levels of satisfaction about the execution of activities of daily living according to the level of amputation or the type of prosthetic limb. Turning to difficulties encountered in performing the 17 detailed daily life activities, the most difficult tasks for the unilateral upper limb amputees were tying shoe laces (63.7%), opening and drinking a bottled beverage with a bottle opener (46.5%), using scissors (42.9%), and buttoning shirts (42.1%) (Table 6). The cosmetic and functional hand groups found tying shoe laces to be most difficult, while the hook hand group found that opening and drinking a bottled beverage with a bottle opener was the hardest task. In terms of level of amputation, the most difficult task for those with shoulder disarticulation, transhumeral or transradial amputation was tying shoe laces, for those with wrist disarticulation it was using scissors, and for those with partial hand and fingers amputation it was buttoning shirts.
Issues related to occupation and driving
On the question of occupation before and after the upper extremity amputation for all the amputees (Table 7), before their amputations 70 (22.8%) subjects had been doing skilled manual work, 68 (21.5%) were in farming, 57 (18.6%) were in the military, and 42 (13.7%) had been office or clerical workers. After their amputations, 122 (39.7%) subjects could not work any longer, while 90 (29.3%) subjects worked at another workplace, 33 (10.7%) performed different tasks at the same workplace, and 27 (8.8%) performed the same tasks at the same work place. Although there were no statistically significant differences in the extent of return to their previous occupations in terms of the different types of prosthetic limb and different levels of amputation, there was tendency for a better extent of return to the original occupation in those with an amputation at a distal site than in those with an amputation was at a proximal site. Although there seemed to be no difference in the extent of return to the previous occupation according to whether or not the amputation was in dominant hand, the extent of return was found to be better for those working in offices than for military personnel, skilled manual workers or common laborers (p<0.05). In addition, those, who had been employed in farming, skilled manual work and common laboring prior to amputation, felt a greater need for rehabilitation training than those in the other occupational groups (p<0.05). On the question of reasons for not being able to return to their occupation following amputation, 143 (51.6%) subjects responded that they could not perform as well as before. The other reasons given (in order of descending frequency) were insufficient function of prosthetic limb (n=45, 16.2%), lack of social awareness about disabled persons (n=32, 11.6%), and continuous pain (n=15, 5.4%). In response to the questions about driving, 62 (20.2%) of all the subjects (unilateral and bilateral amputees) reported they drove prior to amputation. After amputation, 126 subjects (41.0%) stated that they drove, and 34 (26.9%) of this group said that their automobile had been remodeled. On the question of the reasons for not driving after amputation, the largest number of respondents (n=85, 47.0%) answered that they did not drive even before amputation. The next most frequent reason given was that driving with a prosthetic limb is uncomfortable (n=52, 28.7%). Although there were no differences according to side of amputation or type of prosthetic limb between the group which was driving after amputation and the group that was not , those with a more distal site of amputation were more likely to be driving (p=0.001) (for data, see Table 8).
Pain and discomfort experienced by amputees
Amongst all the subjects, 83 (27.0%) respondents reported experiencing pain or discomfort all the time, while 132 (43.0%) reported occasional pain. A group of 38 (12.4%) amputees indicated that the pain occurred when using their prosthetic limbs. On the issue of the types of symptoms related to pain and discomfort, 167 (54.4%) of the subjects complained of tingling at the amputation site, 112 (36.5%) reported pain at the stump, 93 (30.3%) complained of phantom pain, 65 subjects (21.2%) mentioned itching at the amputation site, and 43 (14.1%) reported paresthesia at the amputation site.
Characteristics of bilateral upper limb amputees
Transradial amputation on both sides was the most frequent (n=20, 58.5%) form of bilateral upper limb amputation, and the functional and hook hands were the most frequently used types of prosthetic limb, accounting for 20.6% and 41.2% of the bilateral upper limb amputees, respectively. Functional prosthetic limbs were statistically more frequent in the bilateral upper limb amputees than in the unilateral amputees (p<0.001). On the question of level of satisfaction with the currently used prosthetic limb, 13 (38.2%) subjects responded that they were 'moderate', while 12 (35.3%) were 'satisfied' and 9 (26.5%) were 'dissatisfied'. Most (n=23, 67.6%) used prosthetic limbs for an average of 8-16 hours a day, 4 (11.8%) for 4-8 hours, 3 (8.8%) for less than 4 hours, and 4 (11.8%) hardly ever used them. There were no significant differences between unilateral and bilateral amputees in levels of satisfaction or in average daily durations of use. However, on the question of the extent of usage of a prosthetic limb for daily life activities, 54.5% of the bilateral amputees responded that the prostheses were functionally helpful; this was significantly higher than the corresponding figure for unilateral amputees (p<0.001). In terms of the 17 detailed activities of daily living, the most difficult tasks for the bilateral amputees were (in the order of descending frequency) tying shoe laces (82.4%), buttoning shirts (79.4%), using scissors (76.5%), opening and drinking a bottled beverage with a bottle opener (67.6%), and washing one's face (58.8%) (Table 5). On the question of the extent of return to previous occupation after the amputations, 29 subjects (85.3%), could not return to work, while 5 (14.7%) worked on different tasks at a different workplace. Clearly, none of the bilateral amputees returned to the same workplace or performed the same tasks.
The severing of a part of the human body not only causes functional and psychological disability but also induces social isolation.2 Although enormous efforts have been made in an attempt to overcome these difficulties, the majority of these attempts have been focused on lower extremity amputation.7 Moreover, in the case of unilateral upper limb amputees, most consider a prosthetic limb has an only supplementary role since most of the activities of daily living are conducted by using the upper extremity on the intact side.8,9 Since the level of expectations about prosthetic limbs differs widely and the frequency of upper extremity amputation is lower than that of lower extremity amputation, reports on the actual status of prosthesis usage of upper extremity amputees in Korea remain inadequate.
In the previous research by Song and Park,5 the frequency of amputation level was highest for transradial amputation at 51.9%, followed by 32.8% for transhumeral amputation and 8.2% for shoulder disarticulation. In assessing the cause of amputation, they found high proportions of shrapnel and gunshot injuries (67.9% and 16.8%, respectively). In this study, although the frequency of transradial amputation was the highest, accounting for 48.4% of the unilateral upper limb amputees, the frequencies of transhumeral amputation and shoulder disarticulation (19.4% and 6.6%, respectively) were less than those previously reported, and the frequencies of partial hand and fingers amputation and wrist disarticulation (17.9% and 6.6%, respectively in the two studies) were, higher. Although it is not possible to perform accurate analysis since no assessment of the causes of amputation was made in the present study, these results, when compared with those of the earlier research findings, indicate causes such as shrapnel injury, gunshot injury and damage from explosions, which damage proximal sites of the upper extremity, are decreasing, and that mechanical and electrical causes arising from industrialization, which bring about damage to the distal sites, are increasing.1
In the research reported by Wright et al.10 and Durance and O'Shea,11 the frequencies of the use of functional prosthetic limbs were quite high (84% and 77%, respectively in the two studies). However, previous reports in Korea, which studied the types of prosthetic limb used for the upper extremities, found lower frequencies of functional prosthetic and cosmetic prosthetic limbs (62.5% and 55.5%, respectively, of all the prosthetic limbs for upper extremities.2,8 Moreover, the frequency of cosmetic prosthetic limbs accounted for 79.8% of the total, which is substantially higher than that of functional prosthetic limbs at 1.5%, even in the research by Song and Park.5 In the present study, although the usage of a functional prosthetic limb increased to 15.0%, it was found that 80.2% of the unilateral upper limb amputees are using a cosmetic prosthetic limb. Such findings are believed to be the results of the very low frequency of those receiving rehabilitation training in the usage of a prosthetic limb (7.3%), the majority of the questionnaire respondents being old and familiar only with the prosthetic limb, which was prescribed for them in the past (40.15 years was the mean time since the of amputation) and therefore not having attempted to try a new functional prosthetic limb, and the substantially significant burden of manipulation and adaptation to a functional prosthetic limb.
On the question of the level of satisfaction with a prosthetic limb, the frequency of those reporting it as 'satisfactory' was 30.0%, which is slightly higher than the proportion found in the research by Song and Park,5 but proportion of those who were found to be 'dissatisfied' was still very high at 28.6%. However, 44.7% of unilateral upper limb amputees in the present study reported wearing their prosthetic limbs for an average of 8-16 hours per day. Gaine et al,12 considered that the wearing of prosthetic limb for a daily average of eight hours or more indicated success in the usage of a prosthetic limb and devised a prosthetic success score for which the duration of wearing of prosthetic limb was one of the component scores. The results of the present study demon strate an increase in the daily duration of wearing a prosthesis when compared with the 39.2%, who stated that they always wore their prosthesis, in the study by Song and Park.5 Nevertheless, the present study found that the level of amputation and types of prosthetic limb made no difference to levels of satisfaction or durations of wearing a prosthesis. Moreover, the extent of usage also appeared to be unaffected by the level of amputation and types of prosthetic limb. Most (76.9%) of the unilateral upper limb amputees reported using their prosthetic limb always or occasionally for cosmetic purposes, and this group's the level of satisfaction with their prosthetic was lower than that of the group using their prostheses for functional purposes.
On the questions about 17 detailed activities of daily living, tasks such as tying shoe laces, opening and drinking a bottled beverage with a bottle opener, using scissors and buttoning shirts were found to be more difficult than other activities. In general, there was a tendency for activities to be more difficult to perform, if they required delicate movements and substantial force of the distal extremities. In particular, for those with amputation of the hand or fingers, activities which required delicate movements of the terminal ends of the upper extremities, such as buttoning shirts and using scissors, tended to be more difficult. By adding and examining detailed tasks to the basic activities of daily living, it is thought that the results of the present study will provide information to assist in the development of rehabilitation training programs for upper extremity amputees.
Most of the respondents in the present survey stated that after amputation they were either unemployed or performed different tasks at different workplaces (39.7% and 29.3%, respectively), and only 8.8% returned to the same task at the same workplace. While this is an increase from the 5.5% reported by Chang et al.8, it is still substantially lower than the occupation return rate of 30.4% reported in the research by Gaine et al.12 In addition, it was confirmed that there was no case of a return to the original workplace amongst the bilateral upper limb amputees. Considering the fact that amputation occurred at the average age of 25.70 years and that this age represents a productive stage in people's lives when they have substantial socio-economic capabilities, the socio-economic losses arising from amputation are believed to be enormous. As was the case in the previous researches,13 the results of the present study showed that the extent of return to an occupation was unrelated either to whether the dominant upper extremity was amputated or to the educational background of the amputee. Office workers experience less demand on the functioning of their upper extremities and the extent of their return to their previous occupation was found to be better than for military personnel, skilled manual workers and common laborers. In addition, farmers, skilled manual workers and common laborers, who face greater demands on the functioning of their upper extremities, see rehabilitation training more as more important than others do. On the question of the reasons for failure to return to ones' previous occupation, although an inability to perform as in the past accounted for 51.6% of the answers, many gave reasons such as insufficient functions of a prosthetic limb (16.2%) and lack of social awareness about disabled persons (11.6%). This illustrates that the social awareness about amputees or systems related to occupation rehabilitation is still insufficient. The development of prosthetic limb with faster and more accurate movement functions is also needed.
According to Davidson,6 68% of upper extremity amputees drove vehicles after amputation, with 73% of drivers using handle rotation knobs and 23% having extended winker levers. In the present study, 41.0% of all the amputees stated that they drove after amputation, with 26.9% of them using remodeled automobiles. The subjects were not asked to provide details of types of remodeling, and this makes accurate comparisons difficult, but the proportions of the drivers and the remodeling of automobiles were found to be relatively lower. Moreover, although there were no differences in the side of amputation and types of prosthetic limb between those who did and did not drive after amputation, the drivers and non-drivers were found to differ in terms of the level of the amputation. A statistically larger number of amputees drove if the level of amputation was closer to the distal site. Under the current domestic road and traffic laws of Korea, those, who have lost both arms above the elbow, or those, who are unable to use both arms at all, are not allowed to drive. However, there is exception for the cases in which such people are able to drive normally by using automobiles, which have been designed and built to suitably accommodate for the extent of the physical disabilities of the amputee driver. If rehabilitation services for driving, such as the development and supply of assistive devices appropriate for driving, are improved and if there is an expansion of rehabilitation centers for driving, then the proportion of upper limb amputees who drive will increase. This should improve their activities of daily living and also increase their satisfaction levels with their prosthetic limbs.
This study is limited in the extent to which the results can be generalized to everyone with upper extremity amputations, since subjects included only the patients who were prescribed prosthetic limbs for their upper extremities at a single hospital; furthermore, all the subjects were male and elderly. A second limitation is the study relied upon a postal questionnaire survey for the collection of data, and more detailed and useful information could have been obtained from the amputees by the use of personal interviews.
However, this study is meaningful in comparison to the previous researches in that it investigated a range of issues, including levels of satisfaction, the actual status of usage of a prosthetic limb for the upper extremities, activities of daily living, and the impacts on occupations and driving. It is believed that the findings of this study could be used in the future as basic information for the prescription and training for use of upper extremity prosthetic limbs and for rehabilitation training in relation to returning to employment.
This study used a postal questionnaire survey of patients with upper extremity amputations to investigate their current use of prosthetic limbs and levels of satisfaction in relation to their activities of daily living, occupation and driving. Although the extent of return to previous employment is considered to be improving, it is still highly unsatisfactory when compared with data from overseas countries. Moreover, it seems that a prosthetic limb for the upper extremities has greater significance for cosmetic and supplementary purposes than functional purposes. Finally, there appears to be a need for: firstly, the development of prosthetic limbs with functions more closely approximating the normal functions of the upper extremities; secondly, changes in social awareness about the amputees; and, thirdly, the establishment of policies designed to improve occupational rehabilitation.
  • 1. Kim YC, Park CI, Kim DY, Kim TS, Shin JC. Statistical analysis of amputations and trends in Korea. Prosthet Orthot Int 1996;20:88-95.
  • 2. Cho ES, Moon HW, Kim YH, Choi YT. A follow-up study of upper extremity amputees about their status of rehabilitation. J Korean Acad Rehabil Med 1990;14:241-246.
  • 3. Pylatiuk C, Schulz S, Döderlein L. Results of an internet survey of myoelectric prosthetic hand users. Prosthet Orthot Int 2007;31:362-370.
  • 4. Stein RB, Walley M. Functional comparison of upper extremity amputees using myoelectric and conventional prostheses. Arch Phys Med Rehabil 1983;64:243-248.
  • 5. Song MJ, Park YO. Prosthetic use in upper limb amputees. J Korean Acad Rehabil Med 1988;12:117-124.
  • 6. Davidson J. A survey of the satisfaction of upper limb amputees with their prostheses, their lifestyles, and their abilities. J Hand Ther 2002;15:62-70.
  • 7. Min SK, Yang CS, Kim EK, Chung BJ, Lee WY. Fitting of a myoelectric hand for wrist disarticulation. J Korean Acad Rehabil Med 1998;22:248-251.
  • 8. Chang YU, Park SH, Park DS, Jang KU. Use of prosthesis in the burn induced upper extremity amputees. J Korean Acad Rehabil Med 1999;23:1249-1259.
  • 9. Smurr LM, Gulick K, Yancosek K, Ganz O. Managing the upper extremity amputee: a protocol for success. J Hand Ther 2008;21:160-176.
  • 10. Wright TW, Hagen AD, Wood MB. Prosthetic usage in major upper extremity amputations. J Hand Surg Am 1995;20:619-622.
  • 11. Durance JP, O'Shea BJ. Upper limb amputees: a clinic profile. Int Disabil Stud 1988;10:68-72.
  • 12. Gaine WJ, Smart C, Bransby-Zachary M. Upper limb traumatic amputees. Review of prosthetic use. J Hand Surg Br 1997;22:73-76.
  • 13. Burger H, Maver T, Marincek C. Partial hand amputation and work. Disabil Rehabil 2007;29:1317-1321.
Appendix

Questionnaire

arm-35-907-a001.jpg
arm-35-907-a002.jpg
arm-35-907-a003.jpg
arm-35-907-a004.jpg
arm-35-907-a005.jpg
Table 1
General Characteristics of Patients (n=307)

*Values are expressed as means±standard deviation

arm-35-907-i001.jpg
Table 2
Level of Amputation in Unilateral Upper Limb Amputees (n=273)
arm-35-907-i002.jpg
Table 3
Satisfaction with Prostheses in Unilateral Upper Limb Amputees (n=273)

SD: Shoulder disarticulation, TH: Transhumeral amputation, ED: Elbow disarticulation, TR: Transradial amputation, WD: Wrist disarticulation, HA: Partial hand & fingers amputation, CH: Cosmetic hand, FH: Functional hand, HH: Hook hand

arm-35-907-i003.jpg
Table 4
Prosthesis Daily Wearing Time in Unilateral Upper Limb Amputees (n=273)

SD: Shoulder disarticulation, TH: Transhumeral amputation, ED: Elbow disarticulation, TR: Transradial amputation, WD: Wrist disarticulation, HA: Partial hand & fingers amputation, CH: Cosmetic hand, FH: Functional hand, HH: Hook hand

arm-35-907-i004.jpg
Table 5
Level of Individual Functional Activities in Unilateral Limb Amputees (n=273)

*p<0.05

arm-35-907-i005.jpg
Table 6
Difficulties in Use of Prosthesis in Activities of Daily Living (n=307)
arm-35-907-i006.jpg
Table 7
Occupation at Time of Injury (n=307)

*p<0.05

arm-35-907-i007.jpg
Table 8
Driving Status after Amputation in Unilateral Upper Limb Amputees (n=273)

SD: Shoulder disarticulation, TH: Transhumeral amputation, ED: Elbow disarticulation, TR: Transradial amputation, WD: Wrist disarticulation, HA: Partial hand & fingers amputation, CH: Cosmetic hand, FH: Functional hand, HH: Hook hand

*p=0.001

arm-35-907-i008.jpg

Figure & Data

References

    Citations

    Citations to this article as recorded by  
    • UTILITY OF BODY-POWERED VOLUNTARY OPENING AND CLOSING TERMINAL DEVICES ON TRANSRADIAL PROSTHESES
      Roland Paquette, Owen Hill, Stephanie L. Carey, Matthew Wernke, Derek Lura, Ashley Knight, Jason T. Kahle, Rebecca M. Miro, M. Jason Highsmith
      Technology and Innovation.2025; 24(1): 46.     CrossRef
    • A National Analysis of Targeted Muscle Reinnervation following Major Upper Extremity Amputation
      Lauren Valentine, Allan A. Weidman, Jose Foppiani, Angelica Hernandez Alvarez, Erin Kim, Natalie E. Hassell, Nicholas Elmer, Toni F. Engmann, Samuel J. Lin, Sammy Dowlatshahi
      Plastic & Reconstructive Surgery.2025; 155(3): 566.     CrossRef
    • Reliability and Validity of the Survey on Activities of Daily Living and Occupations of Upper Extremity Amputees’ Turkish Version
      Aslı Bebek, Sevilay Karahan, Semra Topuz
      JPO Journal of Prosthetics and Orthotics.2025;[Epub]     CrossRef
    • Offline Versus Real-Time Grasp Prediction Employing a Wearable High-Density Lightmyography Armband: On the Control of Prosthetic Hands
      Bonnie Guan, Ricardo V. Godoy, Mojtaba Shahmohammadi, Anany Dwivedi, Minas Liarokapis
      IEEE Access.2025; 13: 60672.     CrossRef
    • Outcomes and Preferences for Decision-Making for Upper Limb Prosthetic Care: The Patient Journey: A Scoping Literature Review
      Leslie Wilson, Mark Gutin, Timothy Banh, Elizabeth Gress, Todd Castleberry, Siya Asatkar, Peggy Tahir, Michael P. Douglas, Shane R. Wurdeman
      Archives of Rehabilitation Research and Clinical Translation.2025; 7(2): 100460.     CrossRef
    • Upper-limb prosthetic requirements from the healthcare providers, end-users and relatives' perspectives
      Sofía C. Henao, Simón Cuartas-Escobar, Sara Salazar-Salgado, Ana María Posada-Borrero
      Journal of Hand Therapy.2025;[Epub]     CrossRef
    • Exploring the barriers and facilitators to community reintegration for adults following traumatic upper limb amputation: a mixed methods systematic review
      Abby Hutchison, Kate D’Cruz, Pamela Ross, Sarah Anderson
      Disability and Rehabilitation.2024; 46(8): 1471.     CrossRef
    • Use of his prostheses by a double upper limb amputee 6 years after amputation: From aesthetic to functional considerations, a case report
      Camille Noël, Jean-Michel Viton, Laurent Bensoussan, Maëva Cotinat
      Prosthetics & Orthotics International.2024; 48(6): 653.     CrossRef
    • Advances in prosthetic technology: a perspective on ethical considerations for development and clinical translation
      Hayden Gavette, Cody L. McDonald, Kristin Kostick-Quenet, Ashley Mullen, Bijan Najafi, M. G. Finco
      Frontiers in Rehabilitation Sciences.2024;[Epub]     CrossRef
    • Multimodal fusion of EMG and vision for human grasp intent inference in prosthetic hand control
      Mehrshad Zandigohar, Mo Han, Mohammadreza Sharif, Sezen Yağmur Günay, Mariusz P. Furmanek, Mathew Yarossi, Paolo Bonato, Cagdas Onal, Taşkın Padır, Deniz Erdoğmuş, Gunar Schirner
      Frontiers in Robotics and AI.2024;[Epub]     CrossRef
    • Transhumeral prosthesis use affects upper body kinematics and kinetics
      Julia A. Dunn, Nicholas G. Gomez, Bob Wong, Sarina K. Sinclair, Heath B. Henninger, K. Bo Foreman, Kent N. Bachus
      Gait & Posture.2024; 112: 59.     CrossRef
    • Rewiring the evolution of the human hand: How the embodiment of a virtual bionic tool improves behavior
      Matteo Marucci, Ottavia Maddaluno, Colleen Patricia Ryan, Cristina Perciballi, Simona Vasta, Simone Ciotti, Alessandro Moscatelli, Viviana Betti
      iScience.2024; 27(6): 109937.     CrossRef
    • Anthropomorphic Robotic Hand Prosthesis Developed for Children
      Pablo Medina-Coello, Blas Salvador-Domínguez, Francisco J. Badesa, José María Rodríguez Corral, Henrik Plastrotmann, Arturo Morgado-Estévez
      Biomimetics.2024; 9(7): 401.     CrossRef
    • Color Modification of Silicone-Based Prosthetic Finger by 3D-Printed Mold
      Wilson Sutanto Tan, Christian Harito, Grasheli Kusuma Andhini, Marcel Martawidjaja, Nico Chainando, Muhammad Syafi’i, Ketut Bagus Putra, Muhammad Syafrudin
      Prosthesis.2024; 6(5): 1017.     CrossRef
    • Transhumeral prosthesis use and disuse affects whole-body angular momentum
      Julia A. Dunn, Nicholas G. Gomez, Bob Wong, Sarina K. Sinclair, K. Bo Foreman, Kent N. Bachus, Heath B. Henninger
      Clinical Biomechanics.2024; 120: 106365.     CrossRef
    • Functional assessment of current upper limb prostheses: An integrated clinical and technological perspective
      Patricia Capsi-Morales, Cristina Piazza, Lis Sjoberg, Manuel G. Catalano, Giorgio Grioli, Antonio Bicchi, Liselotte M. Hermansson, Andrea Tigrini
      PLOS ONE.2023; 18(8): e0289978.     CrossRef
    • Karla: A Simple and Affordable 3-D Printed Body-Powered Prosthetic Hand with Versatile Gripping Technology
      Ardianto Satriawan, Wildan Trusaji, Dradjad Irianto, Isa Anshori, Casi Setianingsih, Erza Nurtriandari, Rachmat Zulkarnain Goesasi
      Designs.2023; 7(2): 37.     CrossRef
    • Long-term upper-extremity prosthetic control using regenerative peripheral nerve interfaces and implanted EMG electrodes
      Philip P Vu, Alex K Vaskov, Christina Lee, Ritvik R Jillala, Dylan M Wallace, Alicia J Davis, Theodore A Kung, Stephen W P Kemp, Deanna H Gates, Cynthia A Chestek, Paul S Cederna
      Journal of Neural Engineering.2023; 20(2): 026039.     CrossRef
    • Categorization and Evaluation Methods for Control Strategies of Bilateral Tasks in Arm Prosthetics
      Tom Hetto, Stefan Schulz, Markus Reischl
      IEEE Access.2023; 11: 52501.     CrossRef
    • A Review of Myoelectric Control for Prosthetic Hand Manipulation
      Ziming Chen, Huasong Min, Dong Wang, Ziwei Xia, Fuchun Sun, Bin Fang
      Biomimetics.2023; 8(3): 328.     CrossRef
    • Replantation versus transplantation: Where do we stand?
      Lindsay E. Janes, Christine McAndrew, L. Scott Levin
      European Journal of Orthopaedic Surgery & Traumatology.2023; 34(7): 3727.     CrossRef
    • Task-Oriented Design of a Multi-Degree of Freedom Upper Limb Prosthesis With Integrated Myocontrol and Sensory Feedback
      Jumpei Kashiwakura, Patrick Gabriel Sagastegui Alva, Irene Mendez Guerra, Conrad Bona, S. Farokh Atashzar, Dario Farina
      IEEE Transactions on Medical Robotics and Bionics.2023; 5(4): 1067.     CrossRef
    • A Review on the Usability, Flexibility, Affinity, and Affordability of Virtual Technology for Rehabilitation Training of Upper Limb Amputees
      Xiangyu Liu, Di Zhang, Ke Miao, Yao Guo, Xinyu Jiang, Xi Zhang, Fumin Jia, Hao Tang, Chenyun Dai
      Bioengineering.2023; 10(11): 1301.     CrossRef
    • A Semiautonomous Control Strategy Based on Computer Vision for a Hand–Wrist Prosthesis
      Gianmarco Cirelli, Christian Tamantini, Luigi Pietro Cordella, Francesca Cordella
      Robotics.2023; 12(6): 152.     CrossRef
    • Enhanced Recognition of Amputated Wrist and Hand Movements by Deep Learning Method Using Multimodal Fusion of Electromyography and Electroencephalography
      Sehyeon Kim, Dae Youp Shin, Taekyung Kim, Sangsook Lee, Jung Keun Hyun, Sung-Min Park
      Sensors.2022; 22(2): 680.     CrossRef
    • Phase-Based Grasp Classification for Prosthetic Hand Control Using sEMG
      Shuo Wang, Jingjing Zheng, Bin Zheng, Xianta Jiang
      Biosensors.2022; 12(2): 57.     CrossRef
    • Employment Status in Individuals with Upper-Limb Amputation: A Survey of Current Trends
      Christina Lee, Susannah Engdahl, Anna Riegger, Alicia Davis, Brian M. Kelly, Deanna H. Gates
      JPO Journal of Prosthetics and Orthotics.2022; 34(2): 79.     CrossRef
    • Benchmarking anthropomorphic hands through grasping simulations
      Immaculada Llop-Harillo, José L Iserte, Antonio Pérez-González
      Journal of Computational Design and Engineering.2022; 9(2): 330.     CrossRef
    • Additive manufacturing of prosthetic hands: a brief overview
      Manish Raj Aryal, Sirjana Pun
      International Journal on Interactive Design and Manufacturing (IJIDeM).2022; 16(3): 1099.     CrossRef
    • Advances in Upper Extremity Prosthetic Technology: Rehabilitation and the Interprofessional Team
      Debra Latour
      Current Physical Medicine and Rehabilitation Reports.2022; 10(2): 71.     CrossRef
    • A Haptic Sleeve as a Method of Mechanotactile Feedback Restoration for Myoelectric Hand Prosthesis Users
      Violet R. Borkowska, Alistair McConnell, Sethu Vijayakumar, Adam Stokes, Aidan D. Roche
      Frontiers in Rehabilitation Sciences.2022;[Epub]     CrossRef
    • Integrating computer vision to prosthetic hand control with sEMG: Preliminary results in grasp classification
      Shuo Wang, Jingjing Zheng, Ziwei Huang, Xiaoqin Zhang, Vinicius Prado da Fonseca, Bin Zheng, Xianta Jiang
      Frontiers in Robotics and AI.2022;[Epub]     CrossRef
    • Influence of lifestyle pattern on preference for prosthetic hands: Understanding the development pathway for 3D-printed prostheses
      Justine Jihyun Kim, Jinseok Kim, Jongsu Lee, Jungwoo Shin
      Journal of Cleaner Production.2022; 379: 134599.     CrossRef
    • Temporal and spatial goal-directed reaching in upper limb prosthesis users
      Christina Lee, Michael A. Gonzalez, Jiyeon Kang, Deanna H. Gates
      Experimental Brain Research.2022; 240(11): 3011.     CrossRef
    • Use of regenerative peripheral nerve interfaces and intramuscular electrodes to improve prosthetic grasp selection: a case study
      Christina Lee, Alex K Vaskov, Michael A Gonzalez, Philip P Vu, Alicia J Davis, Paul S Cederna, Cynthia A Chestek, Deanna H Gates
      Journal of Neural Engineering.2022; 19(6): 066010.     CrossRef
    • Human–Machine Interaction through Advanced Haptic Sensors: A Piezoelectric Sensory Glove with Edge Machine Learning for Gesture and Object Recognition
      Roberto De Fazio, Vincenzo Mastronardi, Matteo Petruzzi, Massimo De Vittorio, Paolo Visconti
      Future Internet.2022; 15(1): 14.     CrossRef
    • B:Ionic Glove: A Soft Smart Wearable Sensory Feedback Device for Upper Limb Robotic Prostheses
      Melanie F. Simons, Krishna Manaswi Digumarti, Nguyen Hao Le, Hsing-Yu Chen, Sara Correia Carreira, Nouf S. S. Zaghloul, Richard Suphapol Diteesawat, Martin Garrad, Andrew T. Conn, Christopher Kent, Jonathan Rossiter
      IEEE Robotics and Automation Letters.2021; 6(2): 3311.     CrossRef
    • Co-Creation Facilitates Translational Research on Upper Limb Prosthetics
      Hannah Jones, Sigrid Dupan, Maxford Coutinho, Sarah Day, Deirdre Desmond, Margaret Donovan-Hall, Matthew Dyson, Thea Ekins-Coward, Laurence Kenney, Agamemnon Krasoulis, Doug McIntosh, Kaveh Memarzadeh, Edward Small, Gemma Wheeler, Hancong Wu, Kianoush Naz
      Prosthesis.2021; 3(2): 110.     CrossRef
    • The Effect of Prosthetics attributes on Impression and Body Image
      Hyung Jin Son, Yuri Lee, Ha Youn Kim
      Journal of the Korean Society of Costume.2021; 71(2): 21.     CrossRef
    • Toward higher-performance bionic limbs for wider clinical use
      Dario Farina, Ivan Vujaklija, Rickard Brånemark, Anthony M. J. Bull, Hans Dietl, Bernhard Graimann, Levi J. Hargrove, Klaus-Peter Hoffmann, He Huang, Thorvaldur Ingvarsson, Hilmar Bragi Janusson, Kristleifur Kristjánsson, Todd Kuiken, Silvestro Micera, Th
      Nature Biomedical Engineering.2021; 7(4): 473.     CrossRef
    • A User-Driven Approach to Prosthetic Upper Limb Development in Korea
      Naan Ju, Kyu-Hye Lee, Myoung-Ok Kim, Youngjin Choi
      Healthcare.2021; 9(7): 839.     CrossRef
    • Co-creation and User Perspectives for Upper Limb Prosthetics
      Hannah Jones, Sigrid Dupan, Matthew Dyson, Agamemnon Krasoulis, Laurence P. J. Kenney, Margaret Donovan-Hall, Kaveh Memarzadeh, Sarah Day, Maxford Coutinho, Kianoush Nazarpour
      Frontiers in Neurorobotics.2021;[Epub]     CrossRef
    • Development of EMG-FMG Based Prosthesis With PVDF-Film Vibrational Feedback Control
      Yuna Choi, Seulah Lee, Minchang Sung, Junho Park, Sungmin Kim, Youngjin Choi
      IEEE Sensors Journal.2021; 21(20): 23597.     CrossRef
    • A survey on what Australians with upper limb difference want in a prosthesis: justification for using soft robotics and additive manufacturing for customized prosthetic hands
      Benjamin Stephens-Fripp, Mary Jean Walker, Eliza Goddard, Gursel Alici
      Disability and Rehabilitation: Assistive Technology.2020; 15(3): 342.     CrossRef
    • Perceptions of ability among adults with upper limb absence: impacts of learning, identity, and community
      Cody L. McDonald, Cynthia L. Bennett, Daniela K. Rosner, Katherine M. Steele
      Disability and Rehabilitation.2020; 42(23): 3306.     CrossRef
    • Risk of depression following traumatic limb amputation—a general population-based cohort study
      Helen Lindner, Scott Montgomery, Ayako Hiyoshi
      Scandinavian Journal of Public Health.2020; 48(3): 289.     CrossRef
    • Towards Including End-Users in the Design of Prosthetic Hands: Ethical Analysis of a Survey of Australians with Upper-Limb Difference
      Mary Jean Walker, Eliza Goddard, Benjamin Stephens-Fripp, Gursel Alici
      Science and Engineering Ethics.2020; 26(2): 981.     CrossRef
    • Experimental Testing of Bionic Peripheral Nerve and Muscle Interfaces: Animal Model Considerations
      Martin Aman, Konstantin D. Bergmeister, Christopher Festin, Matthias E. Sporer, Michael Friedrich Russold, Clemens Gstoettner, Bruno K. Podesser, Alexander Gail, Dario Farina, Paul Cederna, Oskar C. Aszmann
      Frontiers in Neuroscience.2020;[Epub]     CrossRef
    • Obstacles to Prosthetic Care—Legal and Ethical Aspects of Access to Upper and Lower Limb Prosthetics in Germany and the Improvement of Prosthetic Care from a Social Perspective
      Martina F. Baumann, Daniel Frank, Lena-Charlotte Kulla, Thomas Stieglitz
      Societies.2020; 10(1): 10.     CrossRef
    • Upper limb amputation; Care needs for reintegration to life: An integrative review
      Hooman Shahsavari, Pegah Matourypour, Shahrzad Ghiyasvandian, Azam Ghorbani, Fatemeh Bakhshi, Mokhtar Mahmoudi, MohammadReza Golestannejad
      International Journal of Orthopaedic and Trauma Nursing.2020; 38: 100773.     CrossRef
    • State of the Art in Bionic Hands
      Hirakjyoti Basumatary, Shyamanta M. Hazarika
      IEEE Transactions on Human-Machine Systems.2020; 50(2): 116.     CrossRef
    • A case report: Transhumeral amputee treatment with osseointegrated prosthesis and rehabilitation
      Banda Ricardo, Castillo Jessica, Velez Juan Carlos
      Journal of Hand Therapy.2020; 33(2): 263.     CrossRef
    • Brain (re)organisation following amputation: Implications for phantom limb pain
      Tamar R. Makin, Herta Flor
      NeuroImage.2020; 218: 116943.     CrossRef
    • The Motor Cortex Has Independent Representations for Ipsilateral and Contralateral Arm Movements But Correlated Representations for Grasping
      John E Downey, Kristin M Quick, Nathaniel Schwed, Jeffrey M Weiss, George F Wittenberg, Michael L Boninger, Jennifer L Collinger
      Cerebral Cortex.2020; 30(10): 5400.     CrossRef
    • Upper extremity replantation and revascularization in Finland between 1998 and 2016
      Joonas Pyörny, Tuomas T. Huttunen, Ville M. Mattila, Jarkko Jokihaara
      Journal of Plastic Surgery and Hand Surgery.2020; 54(5): 297.     CrossRef
    • Is an artificial limb embodied as a hand? Brain decoding in prosthetic limb users
      Roni O. Maimon-Mor, Tamar R. Makin, Karunesh Ganguly
      PLOS Biology.2020; 18(6): e3000729.     CrossRef
    • Understanding Limb Position and External Load Effects on Real-Time Pattern Recognition Control in Amputees
      Yuni Teh, Levi J. Hargrove
      IEEE Transactions on Neural Systems and Rehabilitation Engineering.2020; 28(7): 1605.     CrossRef
    • Less is more
      Heng Li
      Review of Cognitive Linguistics.2020; 18(2): 519.     CrossRef
    • Wearable multichannel haptic device for encoding proprioception in the upper limb
      Patrick G Sagastegui Alva, Silvia Muceli, S Farokh Atashzar, Lucie William, Dario Farina
      Journal of Neural Engineering.2020; 17(5): 056035.     CrossRef
    • Talking with Your (Artificial) Hands: Communicative Hand Gestures as an Implicit Measure of Embodiment
      Roni O. Maimon-Mor, Emeka Obasi, Jenny Lu, Nour Odeh, Stephen Kirker, Mairéad MacSweeney, Susan Goldin-Meadow, Tamar R. Makin
      iScience.2020; 23(11): 101650.     CrossRef
    • Test rig design for upper-limb socket prosthetics at transradial amputation level
      M M Bondok, M A El-Sheikh, M A El-Hadek
      IOP Conference Series: Materials Science and Engineering.2020; 973(1): 012011.     CrossRef
    • Re-assessing the Design Needs of Trans-Radial Amputees in Product Design Innovation
      Muhammad Jameel Mohamed Kamil, Sarah Moi Li Shi, Mohd Najib Abdullah Sani
      Wacana Seni Journal of Arts Discourse.2020; 19: 61.     CrossRef
    • Dimensionality Reduction and Motion Clustering During Activities of Daily Living: Decoupling Hand Location and Orientation
      Yuri Gloumakov, Adam J. Spiers, Aaron M. Dollar
      IEEE Transactions on Neural Systems and Rehabilitation Engineering.2020; 28(12): 2955.     CrossRef
    • Functional Outcomes of Major Upper Extremity Replantation: A Scoping Review
      Maleka Ramji, Anna K. Steve, Zahra Premji, Justin Yeung
      Plastic and Reconstructive Surgery - Global Open.2020; 8(10): e3071.     CrossRef
    • The Functionality of the Bio-Mechanical Prosthetic Finger When Compared With Results on Standardized and Functional Assessments: A Single-Case Study
      Susan P. Denham, Taylor Hawkins, Kelsey Johnson, Jenna Rhoads, Sara Sims
      JPO Journal of Prosthetics and Orthotics.2019; 31(2): 140.     CrossRef
    • The Comparative Effect of Cosmetic and Mechanical Prosthesis on Quality of Life and Performance in People With Medium-Length Below-Elbow Amputation
      Atiye Moradi-Hades, Farzad Farmani, Mohammad Ali Mardani, Mahmood Bahramizadeh, Rashid Heidarimoghadam
      JPO Journal of Prosthetics and Orthotics.2019; 31(2): 89.     CrossRef
    • Design and Evaluation of a Surface Electromyography-Controlled Steering Assistance Interface
      Edric John Cruz Nacpil, Zheng Wang, Rencheng Zheng, Tsutomu Kaizuka, Kimihiko Nakano
      Sensors.2019; 19(6): 1308.     CrossRef
    • Assessment of body-powered 3D printed partial finger prostheses: a case study
      Keaton J. Young, James E. Pierce, Jorge M. Zuniga
      3D Printing in Medicine.2019;[Epub]     CrossRef
    • Bionic reconstruction
      Martin Aman, Christopher Festin, Matthias E. Sporer, Clemens Gstoettner, Cosima Prahm, Konstantin D. Bergmeister, Oskar C. Aszmann
      Wiener klinische Wochenschrift.2019; 131(23-24): 599.     CrossRef
    • A conceptual framework for orthotic and prosthetic education
      Susan E Spaulding, Ann Yamane, Cody L McDonald, Scott A Spaulding
      Prosthetics & Orthotics International.2019; 43(4): 369.     CrossRef
    • Prosthetic hand control: A multidisciplinary review to identify strengths, shortcomings, and the future
      Dinesh K. Kumar, Beth Jelfs, Xiaohong Sui, Sridhar P. Arjunan
      Biomedical Signal Processing and Control.2019; 53: 101588.     CrossRef
    • Users’ and therapists’ perceptions of myoelectric multi-function upper limb prostheses with conventional and pattern recognition control
      Andreas W. Franzke, Morten B. Kristoffersen, Raoul M. Bongers, Alessio Murgia, Barbara Pobatschnig, Fabian Unglaube, Corry K. van der Sluis, Greg Wood
      PLOS ONE.2019; 14(8): e0220899.     CrossRef
    • Alterations in Brain Structural Connectivity After Unilateral Upper-Limb Amputation
      Xiaoli Guo, Ruihao Liu, Jincheng Lu, Chaowei Wu, Yuanyuan Lyu, Zhuo Wang, Jianbo Xiang, Changjie Pan, Shanbao Tong
      IEEE Transactions on Neural Systems and Rehabilitation Engineering.2019; 27(10): 2196.     CrossRef
    • Targeted Muscle Reinnervation: Considerations for Future Implementation in Adolescents and Younger Children
      Kevin J. Zuo, Michael P. Willand, Emily S. Ho, Sandra Ramdial, Gregory H. Borschel
      Plastic & Reconstructive Surgery.2018; 141(6): 1447.     CrossRef
    • Artificial limb representation in amputees
      Fiona M Z van den Heiligenberg, Tanya Orlov, Scott N Macdonald, Eugene P Duff, David Henderson Slater, Christian F Beckmann, Heidi Johansen-Berg, Jody C Culham, Tamar R Makin
      Brain.2018; 141(5): 1422.     CrossRef
    • Factors Influencing Functional Outcomes and Return-to-Work After Amputation: A Review of the Literature
      Benjamin J. Darter, Carolyn E. Hawley, Amy J. Armstrong, Lauren Avellone, Paul Wehman
      Journal of Occupational Rehabilitation.2018; 28(4): 656.     CrossRef
    • Prostheses as extensions of the body: Progress and challenges
      Maria Niedernhuber, Damiano G. Barone, Bigna Lenggenhager
      Neuroscience & Biobehavioral Reviews.2018; 92: 1.     CrossRef
    • Satisfaction of Veterans with Trans-Radial Amputations from Myoelectric Prosthesis and Prosthetic Services Referring to Kowsar Orthotics and Prosthetics Center in Tehran
      J. Heidari, Gh.R. Aminian, M. Bahramizadeh, Elahe Faraji
      Iranian Journal of War and Public Health.2018; 10(3): 165.     CrossRef
    • Neurocognitive barriers to the embodiment of technology
      Tamar R. Makin, Frederique de Vignemont, A. Aldo Faisal
      Nature Biomedical Engineering.2017;[Epub]     CrossRef
    • Adaptable Categorization of Hands and Tools in Prosthesis Users
      Fiona M. Z. van den Heiligenberg, Nick Yeung, Peter Brugger, Jody C. Culham, Tamar R. Makin
      Psychological Science.2017; 28(3): 395.     CrossRef
    • Hand Functions of Myoelectric and 3D-Printed Pressure-Sensored Prosthetics: A Comparative Study
      Kyu Ho Lee, Hobeom Bin, KeunBae Kim, So Young Ahn, Bong-Ok Kim, Soo-Kyung Bok
      Annals of Rehabilitation Medicine.2017; 41(5): 875.     CrossRef
    • Analysis of voluntary opening Ottobock Hook and Hosmer Hook for upper limb prosthetics: a preliminary study
      Nur Afiqah Hashim, Nasrul Anuar bin Abd Razak, Hossein Gholizadeh, Noor Azuan Abu Osman
      Biomedical Engineering / Biomedizinische Technik.2017; 62(4): 447.     CrossRef
    • Literature Review on Needs of Upper Limb Prosthesis Users
      Francesca Cordella, Anna Lisa Ciancio, Rinaldo Sacchetti, Angelo Davalli, Andrea Giovanni Cutti, Eugenio Guglielmelli, Loredana Zollo
      Frontiers in Neuroscience.2016;[Epub]     CrossRef
    • Assessment of body-powered upper limb prostheses by able-bodied subjects, using the Box and Blocks Test and the Nine-Hole Peg Test
      Liz Haverkate, Gerwin Smit, Dick H Plettenburg
      Prosthetics & Orthotics International.2016; 40(1): 109.     CrossRef
    • A comprehensive musculoskeletal and peripheral nervous system assessment of war-related bilateral upper extremity amputees
      Mostafa Allami, Batool Mousavi, Mehdi Masoumi, Ehsan Modirian, Hadi Shojaei, Fatemeh Mirsalimi, Maryam Hosseini, Pirouz Pirouzi
      Military Medical Research.2016;[Epub]     CrossRef
    • Forearm amputees' views of prosthesis use and sensory feedback
      Ulrika Wijk, Ingela Carlsson
      Journal of Hand Therapy.2015; 28(3): 269.     CrossRef
    • Epidemiological Study of Child Casualties of Landmines and Unexploded Ordnances: A National Study from Iran
      Batool Mousavi, Mohammad Reza Soroush, Mehdi Masoumi, Shahriar Khateri, Ehsan Modirian, Hamid Shokoohi, Mohammad Javad Fatemi, Mohammad Ali Hematti, Mansour Soroush, Mohammad Ghassemi-Broumand, Mehdi Rassafiani, Mostafa Allami, Farshad Nouri, Amir Yavari,
      Prehospital and Disaster Medicine.2015; 30(5): 472.     CrossRef
    • An introductory study of common grasps used by adults during performance of activities of daily living
      Margarita Vergara, J.L. Sancho-Bru, V. Gracia-Ibáñez, A. Pérez-González
      Journal of Hand Therapy.2014; 27(3): 225.     CrossRef
    • Influence of standardized activities on validity of Assessment of Capacity for Myoelectric Control
      Helen Y. N. Lindner, Ann-Christin Eliasson, Liselotte M. N. Hermansson
      Journal of Rehabilitation Research and Development.2013; 50(10): 1391.     CrossRef
    • Opinions of Youngsters with Congenital Below-Elbow Deficiency, and Those of Their Parents and Professionals Concerning Prosthetic Use and Rehabilitation Treatment
      Ecaterina Vasluian, Ingrid G. M. de Jong, Wim G. M. Janssen, Margriet J. Poelma, Iris van Wijk, Heleen A. Reinders-Messelink, Corry K. van der Sluis, Nicholas Jenkins
      PLoS ONE.2013; 8(6): e67101.     CrossRef
    • Deprivation-related and use-dependent plasticity go hand in hand
      Tamar R Makin, Alona O Cramer, Jan Scholz, Avital Hahamy, David Henderson Slater, Irene Tracey, Heidi Johansen-Berg
      eLife.2013;[Epub]     CrossRef

    Download Citation

    Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.

    Format:

    Include:

    A Survey on Activities of Daily Living and Occupations of Upper Extremity Amputees
    Ann Rehabil Med. 2011;35(6):907-921.   Published online December 30, 2011
    Download Citation
    Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.

    Format:
    • RIS — For EndNote, ProCite, RefWorks, and most other reference management software
    • BibTeX — For JabRef, BibDesk, and other BibTeX-specific software
    Include:
    • Citation for the content below
    A Survey on Activities of Daily Living and Occupations of Upper Extremity Amputees
    Ann Rehabil Med. 2011;35(6):907-921.   Published online December 30, 2011
    Close
    A Survey on Activities of Daily Living and Occupations of Upper Extremity Amputees
    A Survey on Activities of Daily Living and Occupations of Upper Extremity Amputees

    General Characteristics of Patients (n=307)

    *Values are expressed as means±standard deviation

    Level of Amputation in Unilateral Upper Limb Amputees (n=273)

    Satisfaction with Prostheses in Unilateral Upper Limb Amputees (n=273)

    SD: Shoulder disarticulation, TH: Transhumeral amputation, ED: Elbow disarticulation, TR: Transradial amputation, WD: Wrist disarticulation, HA: Partial hand & fingers amputation, CH: Cosmetic hand, FH: Functional hand, HH: Hook hand

    Prosthesis Daily Wearing Time in Unilateral Upper Limb Amputees (n=273)

    SD: Shoulder disarticulation, TH: Transhumeral amputation, ED: Elbow disarticulation, TR: Transradial amputation, WD: Wrist disarticulation, HA: Partial hand & fingers amputation, CH: Cosmetic hand, FH: Functional hand, HH: Hook hand

    Level of Individual Functional Activities in Unilateral Limb Amputees (n=273)

    *p<0.05

    Difficulties in Use of Prosthesis in Activities of Daily Living (n=307)

    Occupation at Time of Injury (n=307)

    *p<0.05

    Driving Status after Amputation in Unilateral Upper Limb Amputees (n=273)

    SD: Shoulder disarticulation, TH: Transhumeral amputation, ED: Elbow disarticulation, TR: Transradial amputation, WD: Wrist disarticulation, HA: Partial hand & fingers amputation, CH: Cosmetic hand, FH: Functional hand, HH: Hook hand

    *p=0.001

    Table 1 General Characteristics of Patients (n=307)

    *Values are expressed as means±standard deviation

    Table 2 Level of Amputation in Unilateral Upper Limb Amputees (n=273)

    Table 3 Satisfaction with Prostheses in Unilateral Upper Limb Amputees (n=273)

    SD: Shoulder disarticulation, TH: Transhumeral amputation, ED: Elbow disarticulation, TR: Transradial amputation, WD: Wrist disarticulation, HA: Partial hand & fingers amputation, CH: Cosmetic hand, FH: Functional hand, HH: Hook hand

    Table 4 Prosthesis Daily Wearing Time in Unilateral Upper Limb Amputees (n=273)

    SD: Shoulder disarticulation, TH: Transhumeral amputation, ED: Elbow disarticulation, TR: Transradial amputation, WD: Wrist disarticulation, HA: Partial hand & fingers amputation, CH: Cosmetic hand, FH: Functional hand, HH: Hook hand

    Table 5 Level of Individual Functional Activities in Unilateral Limb Amputees (n=273)

    *p<0.05

    Table 6 Difficulties in Use of Prosthesis in Activities of Daily Living (n=307)

    Table 7 Occupation at Time of Injury (n=307)

    *p<0.05

    Table 8 Driving Status after Amputation in Unilateral Upper Limb Amputees (n=273)

    SD: Shoulder disarticulation, TH: Transhumeral amputation, ED: Elbow disarticulation, TR: Transradial amputation, WD: Wrist disarticulation, HA: Partial hand & fingers amputation, CH: Cosmetic hand, FH: Functional hand, HH: Hook hand

    *p=0.001

    TOP