title: Flexible and static wrist units in upper limb prosthesis users: functionality scores, user satisfaction and compensatory movements.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
  
  
  BACKGROUND
  Nederlands Trial Register NTR3984 .
authors.affiliation: Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, P.O. Box 30.001 (CB41), 9700 RB, Groningen, The Netherlands. deijs.marieke@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Deijs
authors.affiliation: Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands.
authors.forename: R M
authors.initials: RM
authors.lastname: Bongers
authors.affiliation: Revant Rehabilitation Center, Brabantlaan 1, 4817 JW, Breda, The Netherlands.
authors.forename: N D M
authors.initials: ND
authors.lastname: Ringeling-van Leusen
authors.affiliation: Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, P.O. Box 30.001 (CB41), 9700 RB, Groningen, The Netherlands.
authors.forename: C K
authors.initials: CK
authors.lastname: van der Sluis
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000674:Amputees / Q000534:rehabilitation*; D001186:Artificial Limbs; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D016059:Range of Motion, Articular / Q000502:physiology; D014955:Wrist Joint
keywords: Compensatory movements; Functionality; Prosthetic limbs; User satisfaction; Wrist