Background: Wrist units with powered rotation (PWR) are commonly prescribed for upper extremity prostheses to improve the user’s ability to position the terminal device for activity tasks; however, little research has assessed how their use is associated with outcomes. Objective: The aim of the study was to compare key outcomes for persons using PWR and passive wrists. Study Design: The study used a cross-sectional, observational cohort of adults with transradial and transhumeral amputation. Methods: Data were collected through physical examination, performance-based testing, prosthesis evaluation, and self-report. Differences in pain, dexterity, activity performance, prosthesis satisfaction, and disability/quality of life between those with a PWR or passive wrist were examined in separate bivariate analyses by amputation level. Four multivariate linear models and a logistic regression model examined the effect of wrist type and controlled for potential confounders. Results: There were 56 people with transradial amputation and 18 with transhumeral amputation. Bivariate comparisons found PWR was associated with slower Jebsen-Taylor Hand Function (JTHF) page turning, higher contralateral limb pain prevalence in the transradial groups, and better prosthesis comfort and embodiment in the transhumeral groups. In multivariate models, PWR was not associated with any outcome measures in either subgroup. Conclusions: Bivariate comparisons found few differences between PWR users and passive wrist users. Multivariate models found no associations with PWR. Further research is needed given the small sample size and limitations in study design. Clinical Relevance Statement: This study did not detect differences in outcomes for users of PWR versus passive prosthesis wrists. However, these findings need to be considered cautiously, in light of the study’s observational design. Until further research is available, clinicians should consider potential advantages of PWR for persons with conditions of the contralateral limb or for those with short or very short transradial amputations as these amputation levels result in more limited forearm pronation and supination in the residual limb. These advantages need to be balanced with potential disadvantages of PWR including increased costs, and potentially heavier weight and complexity of PWR use- (J Prosthet Orthot. 2025;00:00–00 )
Resnik et al. (2026) studied this question.