Multigrip upper limb prosthetics
Topic Status Incomplete
Multi-grip myoelectric upper-limb prosthetics.
Outcome of the appraisal
Multi-grip myoelectric upper limb prosthetics show promise for use by people with upper limb amputation, but the evidence is insufficient to support their routine adoption.
The relative merits of multi-grip myoelectric upper limb prosthetics as compared with other types of prosthetics for upper limb amputees is uncertain and their current use should be determined by individual patient requirements. Further research into the effectiveness of multi-grip myoelectric upper limb prosthetics is recommended, using validated measures of functional and quality of life outcomes.
Why was this topic appraised?
The amputation of part or all of the upper limb is needed for a variety of reasons that include injury or disease. Upper limb prostheses can be used for cosmetic or functional reasons and allow people to accomplish some tasks they would otherwise be unable to do. The absence of all or part of the upper limb can also be a consequence of a birth defect, but this appraisal only looked at use of prostheses by amputees.
Electrically-powered prostheses, commonly known as myoelectric prostheses, are controlled by biological signals from the user’s muscles. Multi-grip myoelectric prostheses provide separate or simultaneous control of each finger through this electrical stimulation. Alternative and simpler devices offer only an open or closed grip (single-grip) which can be either body-powered (via the use of a harness and cables attached to the residual limb) or myoelectrically powered. Multi-grip myoelectric prostheses are currently available to people in Wales but only if an application for an Individual Patient Funding Request is supported.
This topic was suggested to HTW by the Welsh Health Specialised Services Committee.
Plain language summary
Health technology Wales (HTW) assessed the use of multi-grip myoelectric upper limb prosthetics for use by people with upper limb amputation. Amputations are the removal of a part of the body, or limb. Upper limb amputations can include the removal of arms, hands and fingers.
A prosthetic is an artificial limb that is made to replace the one lost. Myoelectric prosthetics are artificial limbs that use the electric signals from the users own muscles to work. These can be either single-grip or multi-grip. Multi-grip myoelectric prosthetics allow users to control each finger of the hand. This allows the prosthetic to be used in more ways.
HTW’s guidance currently does not support routine adoption of multi-grip myoelectric upper limb prosthetics, as while the technology shows promise, there is insufficient evidence that it is the best option for all patients. Further research into the functions of the technology and its impact on patient’s quality of life is recommended.
Topic Exploration Report
TER108 09.2019
Evidence Appraisal Review
EAR014 12.2019
Guidance
GUI014 12.2019
This guidance is currently undergoing reassessment
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