Comparison of Adept Terminal Device to Mechanical Hand Terminal Device for Bimanual Activities in Children
MARY M. LOCAST, O.T.R./L., SHARON SHAPIRO, O.T.R./L., AND JEFFREY ACKMAN, M.D.
This study was undertaken to determine if there was a significant difference in the use of the Adept voluntary closing TD and the mechanical hand TD for functional bimanual activities accomplished by children using conventional below elbow prostheses.
Six patients who had both the Adept and mechanical hand TD's for at least 6 months to use interchangeably participated in this study. Subjects completed a subjective questionnaire regarding overall preference for a TD and were timed and videotaped performing ten standardized bimanual activities with each TD.
Data analysis reveals that while the mechanical hand TD was preferred for its cosmesis, the Adept TD was preferred on all other performance factors and was the preferred TD for the majority of subjects. Based on objective performance data for each subject however, there was no significant difference in performance on the functional activities using the Adept TD vs. mechanical hand. Also noted is that while 4 of 6 subjects cited a personal preference for one TD, they performed faster on a majority of the test items with the opposite TD.
Findings reveal that subjective preference and actual functional performance are to be considered different factors not necessarily related to each other. It should not be assumed that a child will prefer a TD that is most efficient for them, but rather that there may be a multitude of factors contributing to their choice. We further conclude that in older children (over the age 4-5 years), if the child can demonstrate the ability to operate the TD, there can be a reasonable expectation that they will perform as well with the Adept TD. Further studies are needed.
Shriners Hospital for Crippled Children, 2211 N. Oak Park Ave., Chicago, IL 60635