Secondary Logo

Institutional members access full text with Ovid®

Development of the Fundamental Training and Evaluation Tool for the Prosthetic Body-Powered Split Hook

A Preliminary Correlational Study

Nakagawa, Masaki, MS; Sasao, Kumiko, MS; Ishioka, Toshiyuki, PhD; Suzuki, Makoto, PhD; Hamaguchi, Toyohiro, PhD

JPO: Journal of Prosthetics and Orthotics: April 2019 - Volume 31 - Issue 2 - p 104–111
doi: 10.1097/JPO.0000000000000243

Introduction Body-powered split hook training that makes the user focus on somatic sensations may help to improve prosthetic hook operation capacity of individuals with amputation. We have devised the fundamental training for the body-powered split hook (FTBSH) tool, which uses somatic sensations and comprises activities across the domains of time (five items), accuracy (two items), and dexterity (two items), in training for tasks such as opening/closing of body-powered split hook and manipulating objects. We have also devised a tool for assessing the outcomes of this training (FTBSH test).

Materials and Methods The subjects were 5 men who had undergone below-the-elbow amputations. These subjects underwent skills training for 6 weeks using FTBSH, and subsequently another round of training for 6 weeks using time- and dexterity-related training items.

Results Verification of the reproducibility of the FTBSH test revealed significantly high consistency and low error for time- and dexterity-related items. However, accuracy-related items did not demonstrate significant consistency. We administered FTBSH for 6 weeks using time- and dexterity-related items. An examination of the sensitivity to clinical change revealed significant changes in time-related items.

Conclusions These results suggest that time-related items in the FTBSH test are highly reproducible and sensitive to clinical change. Although further studies on the FTBSH are required, the FTBSH shows promise as an effective tool for clinical practice to bring about improvements in operational capacity for individuals with amputation with a prosthetic body-powered split hook.

MASAKI NAKAGAWA, MS; KUMIKO SASAO, MS; TOSHIYUKI ISHIOKA, PhD; MAKOTO SUZUKI, PhD; and TOYOHIRO HAMAGUCHI, PhD, are affiliated with the Department of Occupational Therapy, Graduate School of Health Sciences, Saitama Prefectural University, Koshigaya City, Japan.

MASAKI NAKAGAWA, MS, is affiliated with the Department of Occupational Therapy, National Rehabilitation Center for Persons with Disabilities, Tokorozawa, Japan.

Disclosure: The authors declare no conflicts of interest.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF version of this article on the journal's Web site (

Correspondence to: Toyohiro Hamaguchi, PhD, Department of Occupational Therapy, Graduate School of Health Sciences, Saitama Prefectural University, 820, Sannomiya, Koshigaya City, Saitama Prefecture, 343-8540, Japan; email:

© 2019 by the American Academy of Orthotists and Prosthetists.