Background: The clinical literature includes small observational studies, single-case designs, and a few comparative or training studies evaluating multi-grip myoelectric hands (MHP), single-grip myoelectric hands (SHP), the DEKA/LUKE arm systems, the Utah arm and wrist devices, pediatric prosthesis use, training and pattern-recognition control methods, and osseointegration/OPRA implants.
Evidence scope and limitations: Overall evidence is limited in quantity and quality—many studies are small, nonrandomized, or single-center and outcome measures vary. Systematic and HTA reviews (Hayes, ECRI) found very low-quality or insufficient evidence for LUKE/DEKA and Utah systems and unclear/no support for multi-grip MHPs, noting inconsistent functional improvements versus conventional prostheses.
Study findings: Comparative studies (e.g., Resnik et al. on DEKA) reported reduced perceived disability but mixed or slower performance on some functional tests initially, with some improvements after home training; Kerver et al. (2023) found no clear benefit of MHP over SHP and in some measures SHP outperformed MHP; single-case work (Widehammar et al. 2022) suggested possible self-perceived benefits but was inconclusive.
Training and control research: Pattern-recognition and dual-window classifiers (Earley et al., 2016) and targeted electrode strategies have shown promise for partial-hand control and reduced classification errors in experimental settings, but clinical generalizability is limited.
Pediatrics: Small pediatric series indicate myoelectric prostheses can be successful in young children with strong family support and structured training, but long-term preferences often favor multiple or simpler prostheses.
Osseointegration: Systematic reviews and case series show potential functional advantages (improved ROM, intuitive control via bidirectional interfaces) but are limited by small sample sizes, heterogenous designs, and notable infectious and mechanical complication rates; further comparative and long-term safety studies are needed.
Conclusion: Across device types and populations, the evidence shows inconsistent functional benefits; larger, well-designed, long-term comparative trials and standardized, validated outcome measures are needed to define which patients benefit from specific advanced prosthetic technologies.