EXPLORING FACTORS FOR PRESCRIPTION AND VALIDATION OF ACTUATED UPPER LIMB DEVICES: A CROSS-SECTIONAL SURVEY OF ALLIED HEALTH PROFESSIONALS
Authors: Galbert Angel , Buis Arjan 
Published: September 2024

BACKGROUND: Actuated devices can be beneficial for individuals with upper limb muscle weakness, offering extra force and grip. Utilising this type of assistive device can facilitate daily activities, thereby enhancing independence and overall quality of life. The development of actuated assistive devices has been growing, and current literature shows promise in their clinical use. However, they are not yet medically recommended by global guidelines and councils. Studies have suggested why assistive devices have barriers to access, but actuated devices have not been a focus in these discussions.
OBJECTIVE(S): To address this issue, a survey was conducted among professionals who prescribe and assess upper limb assistive devices. The survey aimed to gather their opinions and quantify the factors that might contribute to the limited use of actuated devices in the field.
METHODOLOGY: A web-based cross-sectional study was designed using Qualtrics, contained 25 items and was conducted between October 2023 and January 2024. The survey was piloted, validated, and ethically approved. Results were statistically analysed, and open questions underwent thematic analysis.
FINDINGS: 87 Allied Health Professionals (AHPs) contributed to the survey, with a completion rate of 69% (60/87). Survey respondents predominately worked from the USA (72%). The survey revealed that 66% of respondents felt they did not have sufficient access to assistive devices and 58% indicated that outcome measures could be improved. They also noted that actuated devices needed to better meet user-centric needs. Barriers to prescribing these devices included a lack of awareness, experience and standardised prescription methods. In addition, the limited time with patients made decision-making and validation of an actuated device difficult.
CONCLUSION: AHP’s have experience prescribing assistive devices but do not have access, knowledge, or clinical methods to assess the use of actuated devices. Future designs for actuated devices should focus on wearability, comfort, user satisfaction, safety and ease of use.
Layman's Abstract
Powered support devices can be helpful for persons with muscle weakness in their arms. These devices can provide support by giving additional strength to the hands. This helps with everyday tasks such as self-care, which in turn also improves quality of life. The development of powered and motorized assistive devices has been growing and current research shows promise in their clinical use. Yet they are not medically recommended by global guidelines and councils. Studies have suggested why all assistive devices have barriers to access, but powered devices have not been a focus in these discussions. This study aims to explore which devices medical professionals use, their opinions on them and how they test them using outcome measures. The survey included 25 questions which were assessed by external researchers and clinicians. The survey was also ethically approved. Overall, 60 people completed the survey. Occupational therapists and hand therapists responded the most and tended to be from the USA. Factors such as lack of awareness, access, and prescription methods were described as barriers to providing powered devices. In addition, the design of the device, function and relevance were concerns. 58% of respondents voted that outcome measures could also be improved. Therefore, prescribers and assessors of assistive devices do not have access to and awareness of current powered devices. Results also showed the function of these devices did not match respondents' opinions on the wearer's needs. The priority should be to make devices that are comfortable and easy to use.
Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/43790/33062
How To Cite: Galbert A, Buis A. Exploring factors for prescription and validation of actuated upper limb devices: A cross-sectional survey of allied health professionals. Canadian Prosthetics & Orthotics Journal. 2024; Volume 7, Issue 1, No.4. https://doi.org/10.33137/cpoj.v7i1.43790
Corresponding Author: Professor Arjan Buis, PhDDepartment of Biomedical Engineering, Faculty of Engineering, University of Strathclyde, Glasgow, Scotland.E-Mail: arjan.buis@strath.ac.ukORCID ID: https://orcid.org/0000-0003-3947-293X