Prosthetic Arm

What is a prosthetic arm?

A prosthetic arm, or upper limb prosthesis, is an artificial replacement for your natural arm. It can replace part or all of your upper limb, from your hand, wrist and forearm to your elbow, upper arm and shoulder. Prosthetic arms can be passive, like a mannequin arm, or high-tech, like a robotic arm.

Who is a prosthetic arm for?

You might be interested in an upper limb prosthesis if you’ve had an arm amputation or you were born with a congenital limb difference that affects its appearance and/or functionality. Different types of prostheses are available for different types of upper limb amputations and limb differences, including:

• Transradial amputation. Amputation through your forearm bones.
• Elbow disarticulation. Amputation at your elbow joint.
• Transhumeral amputation. Amputation above the elbow and through your humerus.
• Shoulder disarticulation. Amputation at your glenohumeral (shoulder) joint.
• Forequarter amputation. Removal of your whole arm, shoulder blade and collarbone.
• Congenital limb deficiency. Underdeveloped arm bones, affecting the length and/or width of your arm.
• Ulnar clubhand. Undeveloped or underdeveloped ulna bone, causing your arm to bend inward.

What is the purpose of a prosthetic arm?

Different types of prosthetic arms serve different purposes. Some are more cosmetic, while others are more functional. Some are designed for everyday tasks, and others are designed for specific activities. If you have an absent arm or arm asymmetry, you might have use for several types of prosthetic arms.

What are the different types of prosthetic arms?

Different types of prosthetic arms replace different parts of your limb as needed. You might need a prosthesis with a shoulder joint, elbow joint and/or wrist joint and a prosthetic hand or other terminal device. Different types also have different purposes and ways of functioning. These types include:

Passive arm prosthesis

A passive arm prosthesis doesn’t function like a human arm, but it can look like one. You can get a custom, lifelike silicone arm (called a silicone restoration) that’s modeled and painted to look just like a natural arm. You can usually position it a few different ways. It’s a popular option for social functions.

Body-powered arm prosthesis

A body-powered arm prosthesis is a mechanical device that operates using a type of pulley system. Cables connect the device to muscles elsewhere on your body, such as your shoulder. You activate these muscles to make the device move. Typically, it has a tool or a claw at the end that can open and close.

Body-powered prostheses are a good option for repetitive tasks and hard manual labor. They’re hardy and weatherproof and don’t need a lot of calibrating to work. The cable and harness system provides sensory feedback when you use it, so you don’t have to watch your prosthesis to know that it’s working.

Activity-specific prosthetic arm

If you need a prosthesis to perform a specific job, sport or hobby, you can get one specifically designed for that purpose. A prosthetist will work with you to design a prosthesis that functions exactly as you need it to. They can customize what’s on the end of it, how it moves and how much weight it can bear.

Activity-specific prosthetic arms can allow you to work with specialized tools, operate machines or work out. They’re easy to swap, and you might use different ones for different activities throughout the day. For example, you might use one type at work and another type at home or while pursuing a hobby.

Myoelectric arm prosthesis

A myoelectric arm prosthesis is an electronic device that operates through electrical impulses generated by your muscles. (Myo- means muscle.) You learn how to squeeze your muscles to trigger the device. Electrodes on your skin read your muscle contractions and signal to the device to make the joints move.

This electrical process uses less force than a body-powered prosthesis, so it’s less stressful on your muscles over time. It can also allow for much more fine-tuned movements. Myoelectric arms have articulating joints, and they typically end in a bionic hand with individually articulating fingers.

This type of prosthesis can enable you to perform a wide variety of everyday tasks. But it’s not always the most practical option for every task. It takes time to calibrate the device to perform the movements you want and skill to initiate complex movements. It’s not ideal for physically stressful work conditions.

Still, a myoelectric arm is a versatile option that can serve both practical and aesthetic purposes. It can look lifelike with a custom silicone overlay, or you can rock a futuristic, robotic look. Those who’ve mastered their bionic arm have relearned how to drive, type on a computer and play the piano with it. 

Hybrid prosthetic arm

Hybrid prosthetics combine myoelectric functions with body-powered ones. For example, a hybrid arm might combine a body-powered elbow joint with a myoelectric hand. This gives you the fine grip control of an articulating hand when you need it, along with the quicker and easier action of the arm when you don’t.

What are the steps involved in getting a prosthetic arm?

Acquiring your own upper limb prosthesis and learning to use it is a huge undertaking. It will take time, practice and patience on your part. And you can expect to get to know your healthcare team really well.

Here’s a brief breakdown of the steps involved:

• Consultation and assessment. The process begins with an assessment and consultation with your healthcare provider. They’ll assess your physical fitness to use a prosthesis, then discuss your lifestyle, needs and goals to determine which type or types of prosthesis will serve you best.
• Fitting. Generally, fitting will take place three to six weeks after amputation surgery. During this process, your prosthetist will determine which muscle groups you’ll use to operate your prosthesis and take careful measurements of your residual limb. They might make a mold or a 3D scan.
• Basic training. When your prosthesis is ready for you, your prosthetist will show you the basics of how it works and how to take care of it. You’ll learn how to put it on and take it off, how to clean it, how to adjust it, and how to operate the different mechanical and electronic parts.
• Physical and occupational training. Next, you’ll work with a physical therapist and/or occupational therapist to learn how to use your prosthesis in your daily life. You’ll strengthen the necessary muscles and drill the necessary movement patterns to accomplish your tasks.
• Mental health care. While you’re working hard to rehabilitate your body, you’re also processing a major psychological event. Don’t underestimate this part. Mental health professionals and peer support groups can help support this part of your journey, along with the physical part.

What are the risks and benefits of using an upper limb prosthesis?

Not everyone with an upper limb deficit chooses to use an arm prosthesis. Some people learn to adapt in other ways — for instance, by using other body parts. A prosthesis is usually heavy, and it takes effort to learn how to use it. Some might feel that the practical benefits of a prosthesis don’t outweigh the costs.

But even if you aren’t overly concerned with the practical benefits of a prosthetic arm, there are health benefits to consider. Using a prosthesis helps your body balance its workload better and distribute stress more evenly among your muscles. Not using a prosthesis can cause you to overuse your opposite side.

This can lead to risks like:

• Unbalanced posture and body alignment.
• Chronic neck pain and/or back pain.
• Repetitive strain injuries on your opposite side.
• Reduced function or range of motion on your different side.

Of course, using a prosthetic arm also comes with potential risks and side effects, including:

• Muscle strains from overusing body-powered prosthetics.
• Mechanical failures and breakdowns and electronic charging issues.
• Pressure sores or chafing due to an improper fit.
• Sweat buildup inside the prosthesis, which will require cleaning.

These risks are mostly avoidable with proper fitting, training and maintenance. It’s also important to keep in mind that you’ll need to work with a physical therapist and occupational therapist to learn adaptive skills to compensate for your limb deficit — whether you decide to use a prosthesis or not.

How long does it take to adapt to a prosthetic arm?

A lot of variables can affect how long it takes to adapt to your new prosthesis, including the type you have, the way you practice, what you want to use it for and any complications you might be having.

Your physical therapist and/or occupational therapist will work with you to design a schedule for practicing skills and exercises that’s customized to your needs. This part can take up to a year.

Learning to use different muscles in different ways to achieve specific actions takes time. Learning to program a bionic arm and toggle between the various movement patterns can take even longer.

While you’re learning to use your prosthetic arm physically, you’ll also be adapting to it mentally and emotionally. Remember to practice patience and self-compassion. This process has its own timeline.

What happens after rehabilitation?

When you and your healthcare team feel you’ve successfully adapted to your new prosthesis, you may not need to continue with physical therapy. Some people do, though — like keeping a physical trainer.

In any case, your relationship with your prosthetist is likely to be a long-term one. You’ll need adjustments and repairs to your prosthesis over the years, as your practical and physical needs may change.

All prosthetics have an expiration date, and you’ll need to repeat the fitting process when that date arrives. Since technology continues to evolve, you may also decide to upgrade your prosthesis before then.

Be sure to call on your healthcare team if discomfort or complications related to your prosthesis develop. Your prosthetist is an important part of your healthcare team. They’ll advise you on treating and preventing complications.

What is targeted muscle reinnervation?

Target muscle reinnervation (TMR) is a new and evolving surgical technique for those undergoing amputation surgery — especially those who are interested in using a myoelectric arm prosthesis.

During amputation surgery, major nerves are severed, and sometimes, the severed nerve endings cause pain. They can develop painful neuromas or trigger phantom limb sensations. TMR can prevent this.

During TMR, a surgeon skilled in nerve work redirects these severed nerves to other muscles in your body. Repairing and grounding the nerve endings can prevent neuromas and chronic pain syndromes.

Redirecting the nerves to other target muscles in your body can also help you operate a myoelectric arm prosthesis. You can train yourself to activate these new muscles in order to operate the prosthesis.

A note from Cleveland Clinic

Prosthetic arm technology has come far in recent years, and modern prosthetics are more functional and versatile than ever before. You’ll be inspired by how much you can do with an upper limb prosthesis if you’re determined to learn how. And your healthcare team can’t wait to help you get there.

But for all this progress, and the innovations still to come, a prosthesis isn’t the same as a natural limb. And there’s no denying the difficulty of substituting a natural limb for a prosthetic one. Your healthcare team knows this, too. When feelings arise, they’ll remind you to balance determination with gentleness.