As the availability of and consumer demand for more advanced and expensive upper limb prosthetic devices increases, so does the need for studies that compare the effectiveness of these devices. The DEKA Arm, also known as the Luke Arm, is an example of a new technologically advanced upper limb prosthesis. The device is available for persons with radial amputation, humeral amputation, and shoulder disarticulation, forequarter amputation or very short transhumeral amputation.
[Photo: Dr. Linda Resnik]
Although the technological capabilities of the DEKA Arm promise increase functionality, limited research has compared functional abilities with the DEKA Arm to function with conventional prostheses and no studies have compared outcomes such as quality of life and community integration. This study, led by Dr. Linda Resnik, professor of health services, policy, and practice, sought to 1) compare self-reported function, dexterity, activity performance, quality of life and community integration of the Gen 3 DEKA Arm to conventional prostheses; and 2) examine differences in outcomes by conventional prosthesis type, terminal device type and by DEKA Arm configuration level.
The Veterans Administration Home Study of an Advanced Upper Limb Prosthesis (Home Study) was a quasi-experimental study that used a time series design. The study had 2 parts: in-laboratory training with the DEKA Arm (Part A) and home use with the DEKA Arm (Part B). Study participants were 23 prosthesis users who completed Part A, and 15 who completed Parts A and B. Outcomes, including self-report and performance measures, were collected at Baseline using participants’ personal prostheses and at the End of Parts A and B.
Results indicated that at the End of Part A activity performance using the DEKA Arm and conventional prosthesis was equivalent, but slower with the DEKA Arm. After Part B, performance using the DEKA Arm surpassed conventional prosthesis scores, and speed of activity completion was equivalent. Participants reported using the DEKA Arm to perform more activities, had less perceived disability, and less difficulty in activities at the End of A and B as compared to baseline. No differences were observed in dexterity, prosthetic skill, spontaneity, pain, community integration or quality of life. Comparisons stratified by device type revealed similar patterns.
Overall, participants using the DEKA Arm had less perceived disability and more engagement of the prosthesis in everyday tasks, although activity performance was slower. After home use experience, activity performance was improved and activity speed equivalent to using conventional prostheses.
The article was published in PLoS One in January.