User ratings of prosthetic usability and satisfaction in VA study to optimize DEKA arm.

The Department of Veterans Affairs study to optimize the DEKA Arm provided feedback to inform optimization of the gen 2 (second-generation) prototype and evaluate the gen 3 (third-generation) prototype. This article summarizes recommendations to improve gen 2 and reports satisfaction and usability ratings of gen 2 and gen 3. Data were collected from 39 subjects; 37 subjects were included in this analysis. Of the subjects, 24 were fit with gen 2 (8 radial configuration [RC], 6 humeral configuration [HC], and 10 shoulder configuration [SC]), 13 were fit with gen 3 (4 RC, 5 HC, and 4 SC), and 5 were fit with both. Usability and satisfaction were evaluated using the Trinity Amputation and Prosthesis Experience Scale (TAPES) and study-specific usability and satisfaction scales. Descriptive statistics were examined and prototypes compared using Wilcoxon rank-sum. Results were stratified by configuration level and outcomes compared by prototype. Satisfaction and usability were greater for gen 3 than gen 2. Overall TAPES scores were similar; however, scores of the TAPES aesthetic satisfaction subscale were higher for gen 3. Compared with gen 2 users, gen 3 users were more satisfied with appearance, grips, and doffing and rated overall usability higher. Features of gen 3, including weight, external cables and wires, hand covering, and fingernails, would benefit from further optimization.