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SP49. Outcomes Of Myoelectric Prosthetic Fitting On Activity Performance In Patients With Traumatic Brachial Plexus Injuries (BPI) After Elective Amputation

Year: 2024

Type: article

Abstract: Purpose: Despite advancements in traumatic brachial plexus injury (BPI) management, reconstructive surgical techniques are not feasible for all patients, leading to amputation. Recently, myoelectric prosthetic capabilities have greatly enhanced terminal prosthetic grasp and release, leading to improved skilfulness of prosthetic use. The aim of this study was to evaluate the function and activity performance of prosthetic fitting with myoelectric controls for upper extremity amputees after BPI. Methods: A retrospective analysis of adult patients with amputation after BPI at a single clinic was performed. Patients that underwent myoelectric prosthesis (MEP) fitting after amputation were included. Demographics, mechanisms of injury, amputation characteristics and outcomes were collected from medical records. The Disabilities of the Arm, Shoulder and Hand (DASH) outcome measure, to evaluate the impact of impairment, Visual Analog Scale (VAS) to evaluate pain, and the Activities Measure for Upper Limb Amputees (AMULA) to evaluate activity performance were collected. Prosthesis usage, satisfaction and signal transducers were also recorded. Paired t-tests were used to compare outcomes. Results: Sixty patients with BPI between were identified. Of these, 13 patients (90% male, average age of 34 years at time of BPI) were fitted with MEPs with electromyographic signal control from muscles not normally associated with the intended function (nonintuitive control) after elective amputation. Among these, 10 patients underwent trans-radial amputation and 3 patients underwent trans-humeral amputations. Amputations occurred to the dominant limb in 3 out of 13 patients. Reasoning for amputation included lack of function or desiring more function.Disability (DASH) did not significantly differ, with average scores of 53 pre-amputation compared to 51 post-amputation (DASH score, p=0.17). Average pain score were also not significantly different post-amputation (6.6 versus 4.4, mean difference 2.2, p=0.054). Linear transducers were used in 60% to fit MEPs and in 40%, traditional electrodes were used. AMULA scores denoted a significant improvement in activity performance after use of prosthesis (p=0.0005). All patients demonstrated functional terminal grasp and release with an average use of 6 hours per day. Hundred percent of patients found their fitted MEP useful during daily activities and were satisfied after an average of 4 months follow-up. Conclusion: Elective upper extremity amputations following BPI did not decrease pain and disability significantly. However, validated AMULA scores found that activity performance using MEPs improved significantly. Patients used their prosthetics around 6 hours per day with a hundred percent satisfaction rate and functional terminal grasp and release.

Source: Plastic & Reconstructive Surgery Global Open

DOI: 10.1097/01.gox.0001015760.24131.9f

Authors: Tiam M. Saffari, Andrew Nelson, Brandon Samson, Clayton Smithers, Nicholas A. Pulos, Alexander Shin

Institution: Mayo Clinic

Language: English

Topic: Prosthetics and Rehabilitation Robotics

Subfield: Biomedical Engineering

Field: Engineering

Domain: Physical Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,195