UC Davis

Despite significant mechatronic advancements in prosthetic hands, achieving the functionality of a biological extremity remains far from realized. For the development of next generation prosthetics and improved patient outcomes, standardized, reliable, and validated task-based evaluation measures are essential. A task-based approach, entailing the manipulation of physical objects with prostheses, directly assesses patient performance in real-time and offersnumerous benefits. Task-based assessments aid clinical decision-making, allowing clinicians to choose the best prosthetic device or strategy for individual patients and enables precise tracking of patient progress, highlighting treatment effectiveness or the need for adjustments. These measures also provide objective data for cost justification in insurance and public health systems, enhancing transparency among stakeholders, including researchers, clinicians, patients, and regulatory bodies. Finally, the standardization of task-based measures facilitates consistent comparisons across different prosthetic devices and control systems, promoting iterative improvement and innovation. Thus, properly implemented standardized evaluation measures are fundamental to the advancement of upper-limb prosthetics.

This thesis critically examines currently available task-based evaluation methods forupper-limb prosthetic technologies, highlighting the gap between the rapid advancement of prosthetic devices and the development of standardized assessment protocols. First, a comprehensive literature review, published in Frontiers in Robotics and AI, revealed that only 25 assessments for upper-limb prostheses have been validated since 1948, highlighting many researchers’ reliance on non-standardized tests that may not have rigorously established validity and not fully address the diverse interests of clinical and research communities. This research then applies theory to practice by using one of the highest rated currently available methods, the Anthropomorphic Hand Assessment Protocol (AHAP), to compare three open-source 3D-printed prosthetic hands with three commercially produced ones. This analysis, currently under review in BMC Biomedical Engineering, illustrates the practical challenges and advancements in prosthetic evaluation and paves the way for a more in-depth discussion on enhancing assessment methodologies. Finally, an online survey about task-based functional measures was conducted to understand and gather insights from diverse practitioners who interact with individuals prescribed upper-limb prostheses. The findings from this survey will influence future task-based evaluation methods and will be presented at the MyoElectric Control Conference in August 2024. This thesis not only provides insights into existing evaluation methods but also pinpoints areas for enhancement, significantly contributing to the development of effective and universally accepted evaluation techniques for upper-limb prostheses.