Dexterity, activity performance, disability, quality of life, and independence in upper limb Veteran prosthesis users: a normative study

Figures & data

Table 1. Brief description of key outcome measures.

	Construct	Item content	Rating criteria	Interpretation
Functional performance
Dexterity
Jebsen-Taylor Hand Function (JTHF)	Dexterity	7 separate tests of fine motor activities: writing, page turning, small objects, eating, placing checkers, light cans, heavy cans	Performance speed; items per second (modified scoring)	Higher scores indicate better dexterity
Nine Hole Peg (NHP)	Dexterity	Accurately place and remove 9 plastic pegs into a pegboard	Timed measure (time limited to 6 min), score calculated as items/second (modified scoring)	Higher scores indicate faster speed, better dexterity
Box and Block	Dexterity	Number of wooden blocks transported in 60 s	Performance speed; total number of blocks transported	Higher scores indicate better performance
Southampton Hand Assessment Procedure (SHAP)	Dexterity/index of function	26 unilateral timed tasks of hand function: 12 abstract tasks and 14 activities of daily (such as zipping, pouring, buttoning)	Performance speed	Higher scores indicate better dexterity
Activity performance
Activities Measure for Upper Limb Amputation (AM-ULA)	Activity performance	18-everyday tasks: brush/comb hair, don t-shirt, doff t-shirt, button shirt, zip jacket, don socks, tie shoes, drink from a cup, use fork, use spoon, pour 12 oz can, write, use scissors, turn doorknob, hammer nail, fold towel, use phone, reach overhead	Each item is rated on task completion: speed, movement quality, skillfulness of prosthesis use and independence. Total score is the average score ×10.	Higher scores indicate better activity performance
Brief Activities Measure for Upper Limb Amputation (BAM-ULA)	Activity performance	10 everyday tasks: tuck in shirt, lift 20 lbs, open and drink from water bottle, remove wallet from back pocket, replace wallet, lift gallon jug, open and pour jug, brush/comb hair, use a fork, open door with round knob	Ability to complete each task (yes/no). Total score is the number of activities that were completed.	Higher scores indicate better activity performance
Timed Measure of Activity Performance (T-MAP)	Activity performance	5 everyday activities: drink from a cup, wash face, food preparation, eating, dressing	Timed Measure: sum of time to complete each activity	Lower scores indicate faster speed, less difficulty
Self-report measures
Device satisfaction
Trinity Amputation and Prosthesis Experience Satisfaction Scale (TAPES)	Prosthetic satisfaction	10 items satisfaction with prosthesis: color, shape, noise, appearance, weight, usefulness, reliability, fit, comfort, and overall satisfaction	Satisfaction	Higher scores indicate greater prosthetic satisfaction
Quick Disability of the Arm, Shoulder, and Hand (QuickDASH)	Disability	Self-reported functional difficulty (8 items), 3 items about sleep, sensation and pain	Performance difficulty and impairment severity	Higher scores indicate greater disability
HRQoL
Veterans RAND 12-Item Health Survey Mental Composite Score (VR-12 MCS)	Quality of life	Measure for Mental Health Component Summary	Self-rated quality of life	Higher scores indicate greater satisfaction
Veterans RAND 12-Item Health Survey Physical Composite Score (VR-12 PCS)	Quality of life	Measure for Physical Health Component Summary	Self-rated quality of life	Higher scores indicate greater satisfaction
Community Reintegration of Injured Service Members-Computer Adapted-Test (CRIS-CAT)	Extent of participation	Computer adaptive testing measuring participation in life roles	Frequency and amount of participation	Higher scores indicate better community integration
CRIS-CAT	Perceived difficulty	Computer adaptive testing measuring participation in life roles	Perceived limitations in participation	Higher scores indicate better community integration
CRIS-CAT	Satisfaction	Computer adaptive testing measuring participation in life roles	Satisfaction with participation	Higher scores indicate better community integration
Need for ADL help	Independence	Any need for help with daily activities	Yes/no	No required help indicates greater independence

Table 2. Demographics and prosthesis characteristics of participants by amputation level (N = 127).

	Unilateral amputation (N = 112)				Bilateral amputation (N = 15)	All (N = 127)
	WD/TR (N = 75)	ED/TH (N = 32)	SH/FQ (N = 5	Total (N = 112)
	Mn (SD)	Mn (SD)	Mn (SD)	Mn (SD)	Mn (SD)	Mn (SD)
Age (years)	56.6 (17.3)	57.1 (16.3)	55.1 (23.4)	56.7 (17.1)	58.5 (10.7)	56.9 (16.5)
Years since amputation	24.2 (19.7)	18.5 (16.1)	23.3 (23.6)	22.5 (18.9)	23.1 (18.8)	22.6 (18.9)
Prosthesis weight (lbs)	3.2 (1.6)	5.2 (2.5)	6.9 (2.9)	3.9 (2.2)	4.1 (2.6)	3.9 (2.3)
	N (%)	N (%)	N (%)	N (%)	N (%)	N (%)
Age category
18 ≤ age < 45	22 (29.3)	5 (15.6)	2 (40.0)	29 (25.9)	2 (13.3)	31 (24.4)
46 ≤ age < 65	20 (26.7)	16 (50.0)	0 (0.0)	36 (32.1)	9 (60.0)	45 (35.4)
66 ≤ age < 75	26 (34.7)	10 (31.3)	3 (60.0)	39 (34.8)	4 (26.7)	43 (33.9)
75+	7 (9.3)	1 (3.1)	0 (0.0)	8 (7.1)	0 (0.0)	8 (6.3)
Gender
Male	73 (97.3)	31 (96.9)	5 (100.0)	109 (97.3)	14 (93.3)	123 (96.9)
Female	2 (2.7)	1 (3.1)	0 (0.0)	3 (2.7)	1 (6.7)	4 (3.2)
Race
White	58 (77.3)	20 (62.5)	5 (100.0)	83 (74.1)	12 (80.0)	95 (74.8)
Black	8 (10.7)	5 (15.6)	0 (0.0)	13 (11.6)	1 (6.7)	14 (11.0)
Mixed/other	9 (12.0)	7 (21.9)	0 (0.0)	16 (14.3)	2 (13.3)	18 (14.2)
Ethnicity
Hispanic	8 (10.7)	7 (21.9)	0 (0.0)	15 (13.4)	1 (6.7)	16 (12.6)
Not Hispanic	63 (84.0)	25 (78.1)	5 (100.0)	93 (83.0)	14 (93.3)	107 (84.3)
Unknown	4 (5.3)	0 (0.0)	0 (0.0)	4 (3.6)	0 (0.0)	4 (3.2)
Employment status^a
Employed full-time	15 (20.0)	6 (18.8)	0 (0.0)	21 (18.8)	1 (6.7)	22 (17.3)
Employed part-time	2 (2.7)	2 (6.3)	0 (0.0)	4 (3.6)	1 (6.7)	5 (3.9)
Student	2 (2.7)	4 (12.5)	0 (0.0)	6 (5.4)	0 (0.0)	6 (4.7)
Retired, employed after amputation	30 (40.0)	10 (31.3)	1 (20.0)	41 (36.6)	5 (33.3)	46 (36.2)
Retired, not employed after amputation	9 (12.0)	3 (9.4)	2 (40.0)	14 (12.5)	4 (26.7)	18 (14.2)
Medical leave	1 (1.3)	2 (6.3)	1 (20.0)	4 (3.6)	3 (20.0)	7 (5.5)
Unknown	16 (21.3)	5 (15.6)	1 (20.0)	22 (19.6)	1 (6.7)	23 (18.1)
Military status
Active duty	2 (2.7)	0 (0.0)	0 (0.0)	2 (1.8)	0 (0.0)	2 (1.6)
Veteran	66 (88.0)	28 (87.5)	5 (100.0)	99 (88.4)	9 (60.0)	108 (85.0)
Civilian	7 (9.3)	4 (12.5)	0 (0.0)	11 (9.8)	6 (40.0)	17 (13.4)
Etiology of amputation^a
Congenital	3 (13.0)	0 (0.0)	0 (0.0)	3 (8.6)	1 (10.0)	4 (8.9)
Combat	27 (44.3)	8 (29.6)	1 (25.0)	36 (39.1)	2 (14.3)	38 (35,9)
Accident	30 (49.2)	15 (55.6)	4 (100.0)	49 (53.3)	9 (64.3)	58 (54.7)
Burn	4 (6.6)	2 (7.4)	0 (0.0)	6 (6.5)	4 (28.6)	10 (9.4)
Cancer	4 (6.6)	1 (3.7)	0 (0.0)	5 (5.4)	0 (0.0)	5 (4.7)
Diabetes	1 (1.6)	0 (0.0)	0 (0.0)	1 (1.1)	0 (0.0)	1 (0.9)
Infection	8 (13.1)	4 (14.8)	0 (0.0)	12 (13.0)	3 (21.4)	15 (14.2)
Prosthesis type
Body powered	45 (60.0)	18 (56.3)	2 (40.0)	65 (58.0)	10 (66.7)	75 (59.1)
Myoelectric single DOF terminal device	12 (16.0)	9 (28.1)	2 (40.0)	23 (20.5)	4 (26.7)	27 (21.3)
Myoelectric multi-DOF terminal device	18 (24.0)	5 (15.6)	1 (20.0)	24 (21.4)	1 (6.7)	25 (19.7)
Terminal device type
Body-powered hook	45 (60.0)	18 (56.3)	2 (40.0)	65 (58.0)	10 (66.7)	75 (59.1)
Externally powered prehensors	7 (9.3)	5 (15.6)	1 (20.0)	13 (11.6)	3 (20.0)	16 (12.6)
Multi-DOF Myo hand	18 (24.0)	5 (15.6)	1 (20.0)	24 (21.4)	1 (6.7)	25 (19.7)
Single-DOF Myo hand	5 (6.7)	4 (12.5)	1 (20.0)	10 (8.9)	1 (6.7)	11 (8.7)
Receipt of any training to use current prosthesis
Yes	20 (26.7)	6 (18.8)	1 (20.0)	27 (24.1)	6 (40.0)	33 (26.0)
No	55 (73.3)	26 (81.3)	4 (80.0)	85 (75.9)	9 (60.0)	94 (74.0)

^a Etiology of amputation: respondents could indicate multiple etiologies.

Table 3. Outcomes by amputation laterality, amputation level.

	Unilateral amputation (N = 112)				All amputation (N = 127)
	WD/TR (N = 75)	ED/TH (N = 32)	SH/FQ (N = 5)	Kruskal–Wallis	Unilateral (N = 112)	Bilateral (N = 15)	WMW
	Mn (SD)	Mn (SD)	Mn (SD)	p Value	Mn (SD)	Mn (SD)	p Value
Dexterity measures
JTHFT
Writing	0.48 (0.29)	0.26 (0.22)	0.13 (0.14	0.0004*	0.41 (0.29)	0.86 (0.23)	<0.0001*
Page turning	0.13 (0.09)	0.05 (0.05)	0.01 (0.02)	<0.0001*	0.10 (0.09)	0.26 (0.16)	<0.0001*
Small objects	0.10 (0.08)	0.04 (0.05)	0.01 (0.02)	<0.0001*	0.08 (0.08)	0.22 (0.15)	<0.0001*
Eating	0.17 (0.11)	0.07 (0.07)	0.00 (0.00)	<0.0001*	0.13 (0.11)	0.22 (0.10)	0.0021*
Checkers	0.09 (0.07)	0.05 (0.06)	0.01 (0.01)	0.0004*	0.07 (0.07)	0.20 (0.14)	0.0001*
Light cans	0.22 (0.13)	0.10 (0.08)	0.06 (0.01)	<0.0001*	0.18 (0.13)	0.40 (0.25)	0.0005*
Heavy cans	0.22 (0.16)	0.09 (0.10)	0.07 (0.04)	<0.0001*	0.18 (0.15)	0.39 (0.23)	0.0002*
Box and Blocks	17.2 (8.4)	8.2 (8.1)	0.8 (1.8)	<0.0001*	13.9 (9.5)	25.7 (7.5)	<0.0001*
9-Hole peg	0.05 (0.05)	0.02 (0.04)	0.0 (.)	0.0205*	0.04 (0.05)	0.13 (0.07)	<0.0001*
SHAP IOF	41.4 (18.3)	11.3 (13.9)	0.6 (1.3)	<0.0001*	31.0 (22.4)	46.2 (21.2)	<0.0001*
Activity measures
AM-ULA	15.3 (6.0)	11.4 (5.2)	9.1 (6.5)	0.0006*	13.9 (6.1)	15.4 (6.9)	0.3659
BAM-ULA	7.3 (2.1)	4.2 (2.8)	.	0.0027*	6.8 (2.5)	8.4 (1.5)	0.1155
T-MAP (min)	4.5 (1.6)	5.5 (2.3)	.	0.0829*	4.8 (1.8)	8.9 (4.5)	0.0027*
Prosthesis satisfaction
TAPES	3.9 (0.7)	3.6 (0.7)	2.7 (1.5)	0.0538	3.8 0.8)	3.9 (0.7)	0.5800
Disability, HRQoL, and community integration
QuickDASH	28.8 (18.4)	31.8 (17.7)	30.0 (19.0)	0.7263	29.7 (18.1)	30.1 (15.6)	0.7514
VR-12 MCS	52.1 (11.1)	50.9 (12.7)	53.9 (8.0)	0.8073	51.8 (11.4)	54.7 (7.2)	0.5958
VR-12 PCS	39.3 (8.7)	38.2 (11.4)	31.6 (13.5)	0.4089	38.6 (9.8)	39.7 (11.5)	0.6115
CRIS-CAT extent	49.1 (9.0)	47.9 (9.4)	46.1 (10.1)	0.6520	48.6 (9.1)	53.6 (7.7)	0.0482
CRIS-CAT perceived	49.0 (7.4)	47.2 (6.0)	44.0 (5.3)	0.1838	48.3 (7.0)	51.2 (9.0)	0.1873
CRIS-CAT satisfaction	50.3 (9.3)	46.6 (5.6)	46.8 (9.0)	0.1543	49.1 (8.5)	52.3 (10.8)	0.2771
	N (%)	N (%)	N (%)	Exact p	N (%)	N (%)	Exact p
Need for ADL help	12 (22.6)	6 (25.0)	2 (50.0)	1.0000	20 (24.7)	7 (58.3)	0.0353

* Significant after Benjamini–Hochberg adjustment with false discovery rate = 0.1. Bold values are those that are statistically significant at p < 0.05.

Table 4. Outcomes of unilateral TR amputation group and normative values of standardized tests.

	Unimpaired males^c			TR unilateral amputations (prothesis side)
	Age group	Side	Mn	Age group	Mn	Ratio of scores
JTHFT (item/s)
Writing	20–59	NonDom	0.74^a	18–44	0.46	0.62
Writing	60–69	NonDom	0.66^a	45–64	0.64	0.97
Writing	70–89	NonDom	0.50^a	65+	0.41	0.82
Page turning	20–59	NonDom	0.90^a	18–44	0.11	0.12
Page turning	60–69	NonDom	1.14^a	45–64	0.17	0.15
Page turning	70–89	NonDom	1.40^a	65+	0.12	0.09
Small objects	20–59	NonDom	1.03^a	18–44	0.10	0.10
Small objects	60–69	NonDom	1.25^a	45–64	0.09	0.07
Small objects	70–89	NonDom	1.35^a	65+	0.10	0.07
Eating	20–59	NonDom	1.58^a	18–44	0.15	0.09
Eating	60–69	NonDom	1.85^a	45–64	0.19	0.10
Eating	70–89	NonDom	2.05^a	65+	0.16	0.08
Checkers	20–59	NonDom	0.95^a	18–44	0.12	0.13
Checkers	60–69	NonDom	1.37^a	45–64	0.09	0.07
Checkers	70–89	NonDom	1.47^a	65+	0.07	0.05
Light cans	20–59	NonDom	0.64^a	18–44	0.27	0.42
Light cans	60–69	NonDom	0.79^a	45–64	0.24	0.30
Light cans	70–89	NonDom	0.97^a	65+	0.18	0.19
Heavy cans	20–59	NonDom	0.62^a	18–44	0.26	0.42
Heavy cans	60–69	NonDom	0.81^a	45–64	0.24	0.30
Heavy cans	70–89	NonDom	0.95^a	65+	0.18	0.19
Box and Blocks	20–44	Left	82.4	18–44	16.9^b	0.21
Box and Blocks	45–64	Left	74.4	45–64	19.3^b	0.26
Box and Blocks	65+	Left	64.4	65+	16.0^b	0.25
Box and Blocks	20–44	Right	84.1	18–44	16.9^b	0.20
Box and Blocks	45–64	Right	75.7	45–64	19.3^b	0.25
Box and Blocks	65+	Right	66.0	65+	16.0^b	0.24
Nine hole peg (item/s)	21–45	Left	0.50^a	18–44	0.04^b	0.08
Nine hole peg (item/s)	46–65	Left	0.44^a	45–64	0.07^b	0.16
Nine hole peg (item/s)	66+	Left	0.37^a	65+	0.04^b	0.11
Nine hole peg (item/s)	21–45	Right	0.52^a	18–44	0.04^b	0.08
Nine hole peg (item/s)	46–65	Right	0.46^a	45–64	0.07^b	0.15
Nine hole peg (item/s)	66+	Right	0.37^a	65+	0.04^b	0.11
SHAP IOF	18–45	Not specified	98.8	18–44	42.9	0.43
SHAP IOF	46–65	Not specified	98.0	45–64	43.6	0.44
SHAP IOF	66–75	Not specified	92.0	65+	39.1	0.43
QuickDASH	20–49	Not applicable	8.0	18–44	31.5	3.94
QuickDASH	50–69	Not applicable	11.5	45–64	28.9	2.52
QuickDASH	70+	Not applicable	18.0	65+	26.8	1.49
VR12 MCS	18–44	Not applicable	38.3	18–44	48.1	1.25
VR12 MCS	45–64	Not applicable	38.8	45–64	49.3	1.27
VR12 MCS	65+	Not applicable	50.9	65+	56.5	1.11
VR12 PCS	18–44	Not applicable	35.3	18–44	41.3	1.17
VR12 PCS	45–64	Not applicable	28.9	45–64	40.4	1.40
VR12 PCS	65+	Not applicable	40.7	65+	37.2	0.91
CRIS-CAT extent	25–60	Not applicable	55.8	18–44	45.4	0.81
CRIS-CAT extent	25–60	Not applicable	55.8	45–64	48.5	0.87
CRIS-CAT perceived	25–60	Not applicable	56.6	18–44	48.1	0.85
CRIS-CAT perceived	25–60	Not applicable	56.6	45–64	48.2	0.85
CRIS-CAT satisfaction	25–60	Not applicable	54.9	18–44	47.9	0.87
CRIS-CAT satisfaction	25–60	Not applicable	54.9	45–64	50.4	0.92

^a Calculation of average items/s is not mathematically exact – instead we use the maximum items possible/average time.

^b Prosthetic side tested.

^c Used only male data when possible (some studies are a mostly male mix).

Table 5. Dexterity outcomes by amputation level and device type (all subjects; bilateral amputation classified by dominant side).

	Transradial				Transhumeral
	Body powered (N = 53)	Myo-single DOF (N = 15)	Myo multi-DOF (N = 19)	K–W	Body powered (N = 20)	Myo-single DOF (N = 10)	Myo multi-DOF (N = 5)	K–W
	Mn (SD)	Mn (SD)	Mn (SD)	p	Mn (SD)	Mn (SD)	Mn (SD)	p
Dexterity
JTHF
Writing	0.56 (0.33)	0.47 (0.27)	0.53 (0.29)	0.5301	0.38 (0.35)	0.23 (0.20)	0.25 (0.17)	0.6274
Page turning	0.17 (0.13)	0.15 (0.09)	0.12 (0.07)	0.2945	0.07 (0.06)	0.04 (0.07)	0.04 (0.04)	0.2432
Small objects	0.13 (0.11)	0.12 (0.12)	0.08 (0.09)	0.0176	0.07 (0.06)	0.03 (0.06)	0.02 (0.02)	0.0110
Eating	0.19 (0.11)	0.17 (0.13)	0.13 (0.09)	0.1275	0.09 (0.09)	0.07 (0.08)	0.04 (0.04)	0.4514
Checkers	0.09 (0.08)	0.13 (0.14)	0.12 (0.08)	0.2988	0.07 (0.07)	0.05 (0.07)	0.03 (0.03)	0.7279
Light cans	0.25 (0.19)	0.23 (0.12)	0.27 (0.15)	0.6802	0.14 (0.11)	0.09 (0.10)	0.11 (0.05)	0.3597
Heavy cans	0.25 (0.22)	0.27 (0.12)	0.25 (0.13)	0.2398	0.09 (0.10)	0.09 (0.10)	0.15 (0.08)	0.2419
Box and Blocks	20.6 (9.2)	15.1 (9.1)	15.4 (6.0)	0.0209*	11.8 (9.8)	5.2 (5.7)	7.6 (6.5)	0.2118
9 hole peg	0.07 (0.06)	0.06 (0.06)	0.01 (0.01)	0.0001*	0.05 (0.06)	0.01 (0.03)	0.00 (0.00)	0.0312
SHAP IOF	44.0 (19.6)	41.0 (21.1)	39.6 (14.8)	0.5697	14.4 (15.3)	10.8 (16.6)	12.8 (12.7)	0.6742

* Significant after Benjamini–Hochberg adjustment with false discovery rate = 0.1. Bold values in this table indicate values statistically significant at p < 0.05.

Table 6. Functional and self-report outcomes by amputation level and device type (unilateral amputation group only).

	Transradial				Transhumeral
	Body powered (N = 45)	Myo-single DOF (N = 12)	Myo multi-DOF (N = 18)	K–W	Body powered (N = 18)	Myo-single DOF (N = 9)	Myo multi-DOF (N = 5)	K–W
	Mn (SD)	Mn (SD)	Mn (SD)	p	Mn (SD)	Mn (SD)	Mn (SD)	p
Dexterity
JTHF
Writing	0.49 (0.30)	0.41 (0.26)	0.52 (0.30)	0.4274	0.29 (0.26)	0.21 (0.20)	0.25 (0.17)	0.8279
Page turning	0.13 (0.09)	0.14 (0.10)	0.12 (0.07)	0.8182	0.06 (0.05)	0.02 (0.03)	0.04 (0.04)	0.1505
Small objects	0.11 (0.07)	0.11 (0.11)	0.07 (0.09)	0.0288	0.07 (0.06)	0.01 (0.02)	0.02 (0.02)	0.0053*
Eating	0.18 (0.12)	0.17 (0.14)	0.14 (0.09)	0.4160	0.08 (0.09)	0.05 (0.06)	0.04 (0.04)	0.5489
Checkers	0.08 (0.06)	0.08 (0.09)	0.12 (0.08)	0.0957	0.06 (0.07)	0.03 (0.05)	0.03 (0.03)	0.5968
Light cans	0.20 (0.13)	0.22 (0.11)	0.28 (0.15)	0.2995	0.12 (0.09)	0.06 (0.07)	0.11 (0.05)	0.2330
Heavy cans	0.20 (0.17)	0.26 (0.12)	0.25 (0.14)	0. 0481	0.08 (0.11)	0.08 (0.09)	0.15 (0.08)	0.1519
Box and Blocks	19.00 (8.73)	14.27 (7.88)	15.28 (6.19)	0.0645	10.53 (9.34)	4.00 (4.47)	7.60 (6.50)	0.2154
9 hole peg	0.06 (0.05)	0.06 (0.06)	0.01 (0.01)	0.0008*	0.04 (0.04)	0.00 (0.00)	0.00 (0.00)	0.0194*
SHAP IOF	42.4 (18.4)	39.3 (23.1)	40.2 (15.0)	0.8298	13.4 (16.2)	6.6 (10.3)	12.8 (12.7)	0.5407
Activity measures
AM-ULA	14.9 (5.3)	14.9 (7.7)	16.4 (6.5)	0.6800	12.3 (6.2)	9.4 (4.2)	11.9 (1.8)	0.2335
BAM-ULA	6.6 (2.1)	9.2 (1.0)	8.0 (1.6)	0.0023*	4.5 (3.4)	4.0 (.)	3.5 (0.7)	0.8307
T-MAP (min)	5.0 (1.8)	3.9 (0.6)	3.9 (0.9)	0.0810	4.6 (1.7)	4.9 (1.2)	7.4 (3.0)	0.1824
Prosthesis satisfaction
TAPES	4.0 (0.7)	3.5 (0.7)	3.8 (0.7)	0.0514	3.7 (0.9)	3.5 (0.5)	3.7 (0.5)	0.6402
Disability, HRQoL, and community integration
QuickDASH	29.2 (19.4)	30.9 (15.8)	26.3 (18.1)	0.7196	34.0 (20.7)	28.2 (13.8)	30.5 (13.3)	0.8488
VR-12 MCS	53.5 (10.1)	46.3 (12.8)	52.4 (11.5)	0.0854	50.4 (13.1)	50.6 (14.6)	52.9 (9.4)	0.9820
VR-12 PCS	37.5 (8.9)	43.2 (6.9)	41.1 (8.2)	0.0854	34.7 (13.2)	41.9 (5.6)	44.0 (8.1)	0.1719
CRIS-CAT extent	50.1 (8.7)	44.6 (9.6)	49.5 (8.8)	0.2424	45.4 (8.3)	50.1 (10.9)	53.2 (8.6)	0.1312
CRIS-CAT perceived	49.4 (6.8)	44.3 (4.7)	51.1 (9.1)	0.0333	46.2 (5.0)	48.3 (7.1)	48.8 (7.9)	0.8735
CRIS-CAT satisfaction	51.2 (9.2)	46.9 (7.7)	50.2 (10.5)	0.3651	45.6 (4.9)	47.9 (5.8)	47.7 (7.9)	0.5518
	N (%)	N (%)	N (%)	exact p	N (%)	N (%)	N (%)	exact p
Need for ADL help	7 (21.2)	3 (37.5)	2 (16.7)	0.5738	3 (25.0)	2 (28.6)	1 (20.0)	1.0000

* Significant after Benjamini–Hochberg adjustment with false discovery rate = 0.1. Bold values in this table indicate values statistically significant at p < 0.05.

Table A1. Normative values for transradial and transhumeral unilateral amputation by age category.

	Unilateral amputation WD/TR			Unilateral amputation ED/TH
	(N = 75)			(N = 32)
	18 to <45	45 to <65	65+	18 to <45	45 to <65	65+
	(N = 22)	(N = 20)	(N = 33)	(N = 5)	(N = 16)	(N = 11)
	Mn (SD)	Mn (SD)	Mn (SD)	Mn (SD)	Mn (SD)	Mn (SD)
Dexterity measures
JTHFT
Writing	0.46 (0.23)	0.64 (0.35)	0.41 (0.26)	0.11 (0.16)	0.30 (0.22)	0.29 (0.24)
Page turning	0.11 (0.07)	0.17 (0.08)	0.12 (0.10)	0.03 (0.05)	0.06 (0.05)	0.05 (0.05)
Small objects	0.10 (0.10)	0.09 (0.07)	0.10 (0.08)	0.02 (0.02)	0.04 (0.05)	0.06 (0.06)
Eating	0.15 (0.10)	0.19 (0.12)	0.16 (0.12)	0.05 (0.05)	0.05 (0.07)	0.10 (0.09)
Checkers	0.12 (0.08)	0.09 (0.07)	0.07 (0.05)	0.06 (0.10)	0.05 (0.06)	0.04 (0.03)
Light cans	0.27 (0.10)	0.25 (0.15)	0.18 (0.13)	0.05 (0.08)	0.10 (0.08)	0.12 (0.09)
Heavy cans	0.26 (0.12)	0.24 (0.16)	0.18 (0.17)	0.05 (0.04)	0.12 (0.11)	0.08 (0.09)
Box and Blocks	16.9 (6.9)	19.3 (8.2)	16.0 (9.3)	3.6 (4.4)	7.7 (7.3)	10.9 (9.8)
9-Hole peg	0.04 (0.04)	0.07 (0.05)	0.04 (0.05)	0.02 (0.04)	0.02 (0.04)	0.03 (0.03)
SHAP IOF	42.9 (15.5)	43.6 (20.1)	39.1 (19.1)	5.8 (8.8)	13.0 (12.9)	11.3 (17.2)
Activity measures
AM-ULA	19.0 (6.5)	16.6 (6.6)	13.2 (5.2)	11.8 (5.0)	11.3 (6.1)	11.3 (4.9)
BAM-ULA	8.5 (1.6)	7.6 (2.3)	6.3 (1.7)	8.0 (.)	2.8 (1.9)	4.8 (3.0)
T-MAP (min)	4.0 (1.0)	4.3 (2.1)	5.1 (1.3)	5.5 (0.9)	5.9 (2.7)	3.2 (0.5)
Prosthesis satisfaction
TAPES	3.8 (0.8)	3.7 (0.7)	4.0 (0.7)	3.8 (0.8)	3.7 (0.8)	3.5 (0.7)
Disability, HRQOL and community integration
QuickDASH	31.5 (18.3)	28.9 (18.8)	26.8 (18.5)	31.6 (19.4)	31.6 (18.3)	32.3 (17.8)
VR-12 MCS	50.0 (13.7)	51.2 (13.0)	59.2 (6.0)	45.8 (13.6)	54.2 (10.8)	50.1 (16.6)
VR-12 PCS	44.2 (8.6)	43.4 (7.2)	40.9 (8.3)	44.8 (12.3)	41.9 (11.6)	39.1 (12.3)
VR-12 MCS imputed	48.1 (13.3)	49.3 (12.8)	56.5 (5.8)	48.8 (14.2)	52.2 (10.4)	49.8 (15.9)
VR-12 PCS imputed	41.3 (8.6)	40.4 (7.2)	37.2 (9.3)	41.5 (10.0)	38.5 (11.9)	36.2 (11.7)
CRIS-CAT extent	45.4 (10.7)	48.5 (9.6)	52.0 (6.1)	44.9 (13.4)	48.2 (9.1)	48.9 (8.4)
CRIS-CAT perceived	48.1 (9.3)	48.2 (7.9)	50.1 (5.4)	45.7 (5.6)	47.6 (6.8)	47.2 (5.4)
CRIS-CAT satisfaction	47.9 (10.3)	50.4 (9.5)	51.8 (8.5)	45.8 (7.2)	47.4 (5.9)	45.9 (4.8)
	N (%)	N (%)	N (%)	N (%)	N (%)	N (%)
Need for ADL help	5 (35.7)	3 (20.0)	4 (16.7)	2 (50.0)	2 (15.4)	2 (28.6)

Table A2. Functional and self-report outcomes by age category and device type (unilateral, transradial amputation only).

	Body powered (N = 45)				Myo-single DOF (N = 12)			Myo multi-DOF (N = 18)
	18–<45	45–<65	66+	18–<45		45–<65	66+	18–<45	45–<65	66+
	(N = 6)	(N = 11)	(N = 28)	(N = 7)		(N = 3)	(N = 2)	(N = 9)	(N = 6)	(N = 3)
	Mn (SD)	Mn (SD)	Mn (SD)	Mn (SD)		Mn (SD)	Mn (SD)	Mn (SD)	Mn (SD)	Mn (SD)
Dexterity
JTHF	0.43 (0.24)	0.70 (0.33)	0.42 (0.27)	0.48 (0.28)		0.38 (0.13)	0.21 (0.30)	0.46 (0.20)	0.65 (0.44)	0.43 (0.12)
Writing	0.12 (0.09)	0.18 (0.08)	0.12 (0.09)	0.12 (0.07)		0.19 (0.12)	0.15 (0.21)	0.10 (0.05)	0.14 (0.07)	0.14 (0.11)
Page turning	0.08 (0.05)	0.10 (0.07)	0.12 (0.08)	0.15 (0.11)		0.06 (0.09)	0.02 (0.01)	0.09 (0.11)	0.06 (0.08)	0.03 (0.03)
Small objects	0.11 (0.07)	0.21 (0.10)	0.18 (0.12)	0.18 (0.13)		0.20 (0.19)	0.10 (0.10)	0.16 (0.08)	0.14 (0.11)	0.07 (0.04)
Eating	0.10 (0.07)	0.09 (0.06)	0.07 (0.06)	0.10 (0.09)		0.08 (0.12)	0.02 (0.02)	0.15 (0.09)	0.10 (0.08)	0.09 (0.04)
Checkers	0.19 (0.10)	0.23 (0.14)	0.20 (0.13)	0.27 (0.07)		0.20 (0.18)	0.09 (0.04)	0.32 (0.11)	0.30 (0.19)	0.11 (0.03)
Light cans	0.16 (0.10)	0.24 (0.19)	0.19 (0.18)	0.29 (0.06)		0.25 (0.22)	0.15 (0.01)	0.32 (0.13)	0.24 (0.10)	0.10 (0.10)
Heavy cans	18.0 (7.9)	23.1 (7.3)	17.6 (9.1)	15.7 (7.2)		12.7 (11.7)	4.5 (4.9)	17.1 (6.7)	15.7 (4.7)	9.0 (4.0)
Box and Blocks	0.04 (0.03)	0.09 (0.04)	0.05 (0.05)	0.07 (0.06)		0.07 (0.07)	0.00 (0.00)	0.01 (0.02)	0.00 (0.00)	0.00 (0.00)
9 hole peg	39.7 (21.2)	46.0 (17.5)	41.6 (18.6)	43.3 (18.1)		37.7 (34.6)	27.5 (33.2)	44.7 (9.7)	42.0 (20.0)	23.3 (2.1)
SHAP IOF
Activity measures
AM-ULA	16.1 (1.4)	17.5 (6.3)	13.7 (5.1)	18.3 (5.8)		11.5 (10.3)	7.8 (3.1)	18.9 (6.7)	15.1 (6.5)	11.3 (2.8)
BAM-ULA	7.5 (0.7)	7.1 (2.8)	6.1 (1.8)	9.2 (1.1)		9.0 (.)	. (.)	8.3 (2.2)	8.0 (1.4)	7.5 (0.7)
T-MAP (min)	4.4 (1.4)	4.7 (2.6)	5.3 (1.4)	3.8 (0.5)		3.5 (0.3)	4.3 (0.8)	3.8 (0.9)	3.8 (1.2)	4.3 (0.2)
Prosthesis satisfaction
TAPES	4.2 (0.6)	3.8 (0.8)	4.1 (0.7)	3.4 (0.9)		3.6 (0.3)	3.9 (0.2)	4.0 (0.7)	3.6 (0.7)	3.7 (0.8)
Disability, HRQOL, and community integration
QuickDASH	27.7 (14.6)	34.1 (21.4)	27.6 (19.7)	39.0 (9.7)		22.0 (22.8)	15.9 (3.2)	28.3 (24.5)	23.0 (9.6)	27.3 (10.4)
VR-12 MCS	52.5 (9.3)	49.6 (15.4)	59.4 (6.5)	44.4 (15.4)		50.2 (6.6)	55.8 (1.0)	52.7 (14.8)	54.5 (11.2)	59.7 (1.8)
VR-12 PCS	45.6 (8.0)	41.8 (7.8)	39.3 (8.1)	45.9 (6.9)		44.9 (8.9)	49.4 (8.6)	41.8 (10.4)	45.8 (5.8)	47.5 (4.8)
VR-12 MCS imputed	50.4 (8.8)	47.5 (15.4)	56.6 (6.3)	42.7 (15.7)		49.6 (6.5)	5.4 (0.0)	50.7 (13.9)	52.4 (10.8)	57.5 (2.6)
VR-12 PCS imputed	42.8 (8.2)	38.7 (7.7)	35.8 (9.2)	43.1 (6.6)		41.5 (8.9)	46.1 (8.3)	39.0 (10.4)	43.0 (5.6)	43.7 (5.4)
CRIS-CAT extent	46.1 (12.7)	47.6 (10.8)	52.0 (6.3)	40.2 (8.9)		49.9 (8.5)	52.2 (7.3)	49.1 (10.0)	49.4 (9.2)	51.3 (5.6)
CRIS-CAT perceived	48.6 (7.4)	47.7 (9.0)	50.3 (5.7)	43.1 (5.4)		45.2 (4.2)	47.0 (3.2)	51.6 (11.7)	50.8 (7.5)	50.6 (4.0)
CRIS-CAT satisfaction	47.7 (7.9)	49.1 (10.9)	52.8 (8.7)	44.2 (7.8)		53.4 (7.1)	46.5 (2.5)	50.9 (13.1)	51.3 (8.5)	45.8 (5.4)
	N (%)	N (%)	N (%)	N (%)		N (%)	N (%)	N (%)	N (%)	N (%)
Need for ADL help	2 (33.3)	2 (28.6)	3 (15.0)	2 (66.7)		1 (33.3)	0 (0.0)	1 (20..0)	0 (0.0)	1 (50.0)

Table A3. Comparison of function participants with unilateral and bilateral amputation: TR body-powered users only.

	Unilateral	Bilateral
	WD/TR (N = 45)	WD/TR (N = 8)	WMW
	Mn (SD)	Mn (SD)	p Value
Dexterity measures
JTHFT
Writing	0.49 (0.30)	0.93 (0.2)	0.0008*
Page turning	0.13 (0.09)	0.36 (0.15)	0.0012*
Eating	0.11 (0.07)	0.27 (0.18)	0.0094*
Small objects	0.18 (0.12)	0.27 (0.08)	0.0287*
Checkers	0.08 (0.06)	0.19 (0.13)	0.0083*
Light cans	0.20 (0.13)	0.51 (0.28)	0.0059*
Heavy cans	0.20 (0.17)	0.53 (0.22)	0.0010*
Box and Blocks	19.0 (8.7)	29.8 (6.2)	0.0035*
9-Hole peg	0.06 (0.05)	0.15 (0.08)	0.0036*
SHAP IOF	42.4 (18.4)	52.9 (25.1)	0.0878*
Activity measures
AM-ULA	14.9 (5.3)	16.8 (5.9)	0.2334
BAM-ULA	6.6 (2.1)	9.0 (0.8)	0.0124*
T-MAP	5.0 (1.8)	7.6 (3.7)	0.0826
Prosthesis satisfaction measures
TAPES	4.0 (0.7)	4.2 (0.4)	0.8044
Disability, HRQoL, and community integration
QuickDASH	29.2 (19.4)	22.7 (13.2)	0.5339
VR-12 MCS	55.8 (10.7)	56.6 (8.9)	0.9569
VR-12 PCS	40.9 (8.1)	46.8 (9.5)	0.0787
VR-12 MCS imputed	53.5 (10.1)	55.2 (8.2)	0.8424
VR-12 PCS imputed	37.5 (8.9)	43.6 (9.1)	0.0865
CRIS-CAT extent	50.2 (8.7)	55.4 (5.9)	0.1265
CRIS-CAT perceived	49.4 (6.8)	53.6 (11.0)	0.2634
CRIS-CAT satisfaction	51.2 (9.2)	52.8 (7.1)	0.4446
	N (%)	N (%)	Exact p
Need for ADL help	7 (21.2)	3 (60.0)	0.1026

* Significant after Benjamini–Hochberg adjustment with false discovery rate = 0.1. Bold values in this table indicate values statistically significant at p < 0.05.