Reported birth prevalences of congenital limb defects (CLD) vary between countries: from 13/10,000 in Finland for the period 1964–1977 to 30.4/10,000 births in Scotland from 1964–1968. Epidemiological studies permit the timely detection of trends in CLD and of associations with other birth defects. The aim of this study is to describe the birth prevalence of CLD in the northern Netherlands.

To describe users’ and therapists’ opinions on multi-function myoelectric upper limb prostheses with conventional control and pattern recognition control. Qualitative interview study. Two rehabilitation institutions in the Netherlands and one in Austria. The study cohort consisted of 15 prosthesis users (13 males, mean age: 43.7 years, average experience with multi-function prosthesis: 3.15 years) and seven therapists (one male, mean age: 44.1 years, average experience with multi-function prostheses: 6.6 years). Four of these users and one therapist had experience with pattern recognition control. This study consisted of semi-structured interviews. The participants were interviewed at their rehabilitation centres or at home by telephone. The thematic framework approach was used for analysis. The themes emerging from prosthesis users and therapists were largely congruent and resulted in one thematic framework with three main themes: control, prosthesis, and activities. The participants mostly addressed (dis-) satisfaction with the control type and the prosthesis itself and described the way they used their prostheses in daily tasks. Prosthesis users and therapists described multi-function upper limb prostheses as more functional devices than conventional one-degree-of-freedom prostheses. Nonetheless, the prostheses were seldom used to actively grasp and manipulate objects. Moreover, the participants clearly expressed their dissatisfaction with the mechanical robustness of the devices and with the process of switching prosthesis function under conventional control. Pattern recognition was appreciated as an intuitive control that facilitated fast switching between prosthesis functions, but was reported to be too unreliable for daily use and require extensive training.

Training increases the functional use of an upper limb prosthesis, but little is known about how people learn to use their prosthesis. The aim of this study was to describe the changes in performance with an upper limb myoelectric prosthesis during practice. The results provide a basis to develop an evidence-based training program.

Video games that aim to improve myoelectric control (myogames) are gaining popularity and are often part of the rehabilitation process following an upper limb amputation. However, direct evidence for their effect on prosthetic skill is limited. This study aimed to determine whether and how myogaming improves EMG control and whether performance improvements transfer to a prosthesis-simulator task. Able-bodied right-handed participants (N = 28) were randomly assigned to 1 of 2 groups. The intervention group was trained to control a video game (Breakout-EMG) using the myosignals of wrist flexors and extensors. Controls played a regular Mario computer game. Both groups trained 20 minutes a day for 4 consecutive days. Before and after training, two tests were conducted: one level of the Breakout-EMG game, and grasping objects with a prosthesis-simulator. Results showed a larger increase of in-game accuracy for the Breakout-EMG group than for controls. The Breakout-EMG group moreover showed increased adaptation of the EMG signal to the game. No differences were found in using a prosthesis-simulator. This study demonstrated that myogames lead to task-specific myocontrol skills. Transfer to a prosthesis task is therefore far from easy. We discuss several implications for future myogame designs.

Task-specific rehabilitation is a key indicator for successful rehabilitation to improve the upper limb performance after stroke. Assistive robotic and non-robotic devices are emerging to provide r...

The current study examines the relevance of prosthetic wrist movement to facilitate activities of daily living or to prevent overuse complaints. Prosthesis hands with wrist flexion/extension capabilities are commercially available, but research on the users’ experiences with flexible wrists is limited. In this study, eight transradial amputees using a myoelectric prosthesis tested two prosthesis wrists with flexion/extension capabilities, the Flex-wrist (Otto Bock) and Multi-flex wrist (Motion Control), in their flexible and static conditions. Differences between the wrists were assessed on the levels of functionality, user satisfaction and compensatory movements after two weeks use. No significant differences between flexible and static wrist conditions were found on activity performance tests and standardized questionnaires on satisfaction. Inter-individual variation was remarkably large. Participants’ satisfaction tended to be in favour of flexible wrists. All participants but one indicated that they would choose a prosthesis hand with wrist flexion/extension capabilities if allowed a new prosthesis. Shoulder joint angles, reflecting compensatory movements, showed no clear differences between wrist conditions. Overall, positive effects of flexible wrists are hard to objectify. Users seem to be more satisfied with flexible wrists. A person’s needs, work and prosthesis skills should be taken into account when prescribing a prosthesis wrist. Nederlands Trial Register NTR3984 .