Abstract:
In recent years there has been a sea change in the field of hand prosthetics, an
increasing number of clinicians and researchers have a desire to be able to
objectively measure the functional effectiveness of a prosthesis, or the ability of a
user with their device. The problem has been that there are many tools to
measure the function of hands and arms, but few seem appropriate to
prosthetics. Also the tools that do exist seem to have conflicting aims and
methods, so it is hard to choose the appropriate test. If practitioners have no
meaningful way to test if a device is better for one user (compared with another
device), they have no easy way to demonstrate to funders or providers that one
solution is more effective than any other. Similarly, they lack a common
language to simply pass on their professional judgement to their colleagues.
What does exist is an array of different tools for measuring different aspects of
prosthetic design, function and use. There is little standardisation between
centres in the same country, let alone across borders and seas. Worse, there is
evidence that existing techniques are being invalidated (conceivably through
ignorance, and definitely due to pressures of time to conduct a truly systematic
study). To save time, or effort, fully validated tests are being shortened, or
favoured sub tests are being selected from the greater whole, so that the results
obtained are incomplete, invalid, or simply wrong.
