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The (cost-)effectiveness of upper limb prostheses

 Research
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Last decades, the cost of upper limb prostheses related health care are rising. One of the reasons may be the more frequent prescription of the multi-grip myoelectric hand prostheses. However, signs of non-usage of the additional grip options of these hands are described. In these cases, a more simple prosthesis might also suit the needs of the user.

Currently, rehabilitation teams do not always have sufficient scientific information to select the hand prosthesis that suits the users’ needs the best. Therefore, the aims of this project were:

  • To investigate the cost-effectiveness of upper limb prostheses.
  • To compare the effectiveness of the multi-grip myoelectric hand prostheses with the standard myoelectric hand prostheses.
  • To develop, implement, and pilot test a web-based decision aid about hand prostheses.

Tailored care: which hand prosthesis is most suitable (dutch language)?

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Cost-effectiveness of upper limb prostheses

A total of 242 upper limb prostheses users completed a quality of life questionnaire, the newly and specifically for this study developed outcome measure to assess the preferred users features of upper limb prostheses, and a cost questionnaire. Results showed that myoelectric prostheses, especially the multi-grip ones, are the most expensive compared to other prostheses types, while no differences in quality of life or user experiences were apparent.

Multi-grip myoelectric hand prostheses versus standard myoelectric hand prostheses

Fourteen multi-grip myoelectric hand prosthesis users performed multiple tests with both the multi-grip and standard myoelectric hand. Additionally, the users’ experiences of the multi-grip myoelectric hand prostheses were compared with the users’ experiences of 19 standard myoelectric hand prosthesis users with questionnaires. Results showed no relevant advantages of the multi-grip hand over the standard hand.

Decision aid about hand prostheses

The decision aid about hand prostheses was developed together with the different stakeholders: prosthesis users, hand/occupational therapists, prosthetists, rehabilitation doctors, implementation experts, and a software developer. The decision aid consists of three parts:

  • Information about the available options of prosthetic hands, hooks, and tools/accessories.
  • In this part, the (potential) prosthesis user is stimulated to consider and indicate what is important for themselves regarding their future prosthesis.
  • Overview of the users’ indicated preferences and the features of the available options. In this way, the (potential) prosthesis user can compare their preferences with the available options.

The decision aid was pilot tested for five months in the real life rehabilitation setting, which showed that both (potential) prosthesis users and health care professionals experience benefits from the decision aid in the prosthesis selection process.
 

    • Dr. Sacha van Twillert, implementation expert

This project is part of

Contact

University Medical Center Groningen (UMCG)
Department of Rehabilitation Medicine
PO Box 30.001
9700 RB Groningen
The Netherlands

Visiting address
University Medical Center Groningen (UMCG)
Department of Rehabilitation Medicine
Hanzeplein 1
9713 GZ Groningen

University Medical Center Groningen (UMCG) - location Beatrixoord
Department of Rehabilitation Medicine
Dilgtweg 5
9751 ND Haren