A Critical Review of Functionality Assessment in Natural and Prosthetic Hands

Abstract

Functionality Is a generic term used when considering the dexterity and manipulative ability provided by both natural and artificial hands. Despite this, there has been little standardised work to quantify this terminology, or to allow the performance of a hand prosthesis to be compared to that of the human hand. this paper details, with wide-ranging emphasis, existing hand assessment procedures developed for both clinical and research applications. The absence of conformity In these protocols, along with a reliance on subjective evaluations, produces concerns over their reliability and validity for providing meaningful Information on hand performance. The assessment of prosthetic hands has been largely dependent on engineering tests and minimal activities of daily living. An evaluation of these procedures reveals a lack of uniformity and, moreover, an inability to quantify the functionality of such devices with respect to a benchmark, such as the human hand. Conclusions from the critical review of both natural and prosthetic hand assessment procedures are used to provide criteria for a standardised and objective protocol for use in a clinical environment, where emphasis on the collation of tangible and repeatable data is as Important as the speed and cost of the procedure.

Establishing a standardized clinical assessment tool of pathologic and prosthetic hand function: Normative data, reliability, and validity

“…11 Existing procedures frequently fail to adhere to medical outcome measurement design criteria or are unable to comprehensively cover the prehensile range of the hand.…”

“…The conclusions of the review 11 highlight that what most procedures have in common is an absence of statistically evident standardization, reliability, and validity. Few procedures are based on the assessment of prehensile patterns.…”

“…The reader is referred to a comprehensive critical review of existing techniques. 11 The review reveals little or no conformity to a standardized procedure for the assessment of hands, both natural and prosthetic. Conventionally, measurement of hand function by these procedures has been by time limit (quantity completed in a finite time period), work limit (time to complete task), qualitative scoring (the way in which the object is handled), or assessor's opinion (eg, level of difficulty for the subject).…”

Contribution to hand functional assessment based on its kinematics

“…As far as functionality of the hand is concerned, the field of study for this thesis is oriented to assess the ability to perform ADL, to provide a general method suitable for dependency assessment in accordance with many other works (Meiners et al 2002;Foki et al 2016;Brinkhorst et al 2016) and with the widely spread physiotherapists' belief that ADL should be considered in treatments . The state of the art has allowed identifying the lack of agreement in the ADL considered in the different works from literature (Light et al 1999;Light et al 2002), which could be solved using the ICF WHO 2001) as it is the only worldwide recognized reference to assess health aspects. In all, the proposal performed in this thesis for selecting the ADL is to choose those activities within the ICF where the hand is directly involved.…”

Development of a lightweight and adaptable multiple-axis hand prosthesis

“…Due to the current prototype format of the control system, user trials cannot be performed, however a series of 'abstract' objects from a standardised and objective hand assessment tool [28,29] were used to evaluate the functional capabilities of the device. The prosthesis can mechanically adapt to form six distinct prehensile patterns, and the secure grasp of the range of spherical, power [see Fig.…”