Outcome Assessment Of Upper Extremity Prosthetic Devices

INTRODUCTION Upper extremity pr osthetic devices have been available in several types, such as body-powered and electromechanical (myoelectricor switch-operated), for many year s There is now a significant interest anriong device developer s and service provider s in scientific studies of the long-term consequences or outcomes associated with device prescription and use. The relevant information is not well-documented at present. Consequently, there are no reliable data to refer to in evaluating and comparing various types of device or device innovations, in relation to their costs or value in terms of outcomes. This makes it difficult to convince research funder s of the need to develop one kind of device over others, or funding agencies to contribute to the costs of more expensive equipment or newer technology, While current development activity is focused on enhancing durability and functionality, service pi ovider's are also concerned about psychosocial outcomes . Acceptance of an upper-limbprosthesis is a complex process that involves occupational, psychological, and socioeconomic factors in addition to the technical performance of the device [7]. The process is further complicated for paediatric clients where issues of child development and family involvement come into play. There is no standard definition, let alone approach to measurement of a successful outcome for upper extremity fitting across ClilliCS and development sites. Minimally, what is needed at this time is a standardized approach to the collection and evaluation of clinical data, such as utilization, satisfaction and rejection rates, and research to determine what other forms of data should be collected in a standardiked fashion to assist developers and service providers in promoting positive outcomes , Our project was developed initially to respond to the specific needs of the Amputee Program at The Hugh MacMillan Rehabilitation Centre (HMRC) in the areas described above. We realized the relevance of our research to other centres in North America, and the importance of developing a longertenn, prospective focus for our work plan, to include multi-centre collaboration in the design of assessment tools and data collection. The project's enhanced scope was ideally suited to the mission of the Ontario Rehabilitation Technology Consortium (ORTC) The Prosthetics and Orthotics Research Team and the Psychosocial Evaluation Team of the ORTC linked up with members of the HMRC clinical services to produce the research plan featured in this report The ORTC is developing innovative rehabilitation technology-based products and services that enhance the lives of persons with disabilities, their families and their commtmities. Initiated in 1991, the ORTC received a commitment of $15 million and a 10-year mandate from the Ontario Ministry of' Health beginning January 1, 1992, under the direction of Dr. Morris Milner at the HMRC. Nine research From "MEC 95," Proceedings of the 1995 MyoElectric Controls/Powered Prosthetics Symposium Fredericton, New Brunswick, Canada: August, 1995. Copyright University of New Brunswick.