Focus of the Report: This health technology assessment focuses on the efficacy and safety of the life under kinetic evolution (LUKE) arm (Mobius Bionics) for adults with upper extremity (or limb) amputation.

Technology Description: Developed by DEKA Research and Development Corporation through funding provided in part by the Defense Advanced Research Project Agency (DARPA), the LUKE arm—known as the DEKA arm during research and development, and marketed as the LUKE arm through Mobius Bionics—is an upper limb prosthesis intended to restore limb function in individuals who have lost all or part of either upper limb. The LUKE arm is primarily controlled by a micro-electromechanical system operated through an inertial measurement unit (IMU) located in a sensor device attached to the top of the shoe. The user commands motion of the prosthesis by either tilting their foot (and the IMU) in various directions or through electromyogram pattern recognition (EMG-PR).

The LUKE arm is available in 3 configurations to fit differing levels of amputation: the radial configuration for transradial amputees, the humeral configuration for transhumeral amputees, and the shoulder configuration for shoulder disarticulation and scapulothoracic (forequarter) amputees. In its maximum configuration, the LUKE arm can provide up to 10 active degrees of freedom (DOF) (or movements), including shoulder abduction, shoulder flexion/extension, humeral rotation, elbow flexion/extension, wrist pronation/supination, wrist flexion/extension, index finger flexion/extension, flexion/extension of other fingers, thumb flexion/extension, and thumb abduction/adduction. Multiple powered DOF can be moved at the same time, and the hand includes a sensor that provides grip force feedback.

Controversy: The LUKE arm offers technological advances not currently available in existing upper extremity prostheses. However, it is expensive, and proper use of the LUKE arm may require lengthy training, with a steep learning curve.

Key Questions:

  • Is the life under kinetic evolution (LUKE) arm effective for treating individuals with upper limb amputation?

  • How does the LUKE arm compare with other upper limb prosthetic devices?

  • Is the LUKE arm safe?

  • Have definitive patient selection criteria been identified for the LUKE arm?