Multi-grip upper limb prosthetics
Topic Status Complete
Multi-grip myoelectric upper-limb prosthetics.
Outcome of the appraisal
The evidence on the use of multi-grip myoelectric upper limb prosthetics by people with upper limb difference remains insufficient to support their routine adoption.
The benefits of multi-grip myoelectric upper limb prosthetics compared with other types of prosthetics for upper limb difference is uncertain, and their current use should be determined by individual patient requirements.
Health Technology Wales recommends the acquisition of data on patient experience and individual patient outcomes for those who have access to these technologies.
Why was this topic appraised?
People who have undergone upper limb amputation or have congenital upper limb reduction can be provided with upper limb prosthetics to restore some of the function of the missing hand or arm. Current standard care involves providing people with a passive (cosmetic) device or a simple open-close (single-grip) device that is body-powered. Devices controlled via an electric motor that responds to electromyographic signals in the remaining musculature (myoelectric) are not routinely available in Wales.
Multi-grip myoelectric upper limb prosthetics allow for a greater variety of grip patterns than single-grip myoelectric or body-powered prosthetics and therefore have the potential to provide increased functionality for users.
This is a re-assessment of these technologies, which HTW first assessed in 2019 (EAR014), and was originally suggested by the Welsh Health Specialised Services Committee.
Plain language summary
Upper limb difference includes:
- being born with parts of the upper limb missing or improperly formed
- amputations – the surgical removal of a part of the body or limb.
Upper limb differences can involve the arms, hands, and fingers. A prosthetic is an artificial limb that is made to replace the one removed or missing. Myoelectric prosthetics are artificial limbs that use the electric signals from the user’s 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 separately. This allows the prosthetic to be used in more ways.
Health Technology Wales looked for evidence on the clinical and cost effectiveness of multi-grip myoelectric upper limb prosthetics for use by people with upper limb difference. There is still not enough evidence in this area to support routine adoption of these technologies. The benefits of multi-grip myoelectric upper limb prosthetics compared with other types of prosthetics for upper limb difference are uncertain. Their current use should be determined by individual patient requirements. Health Technology Wales recommends the gathering of more data on patient experience and individual patient outcomes for those who have access to these technologies
Topic Exploration Report
Evidence Appraisal Review
This is an updated version of an appraisal. HTW originally issued guidance on this topic in December 2019. The guidance and supporting documents from previous appraisals are available from HTW upon request.