Linda Resnik1,2, Frantzy Acluche1, Matthew Borgia1, Jill Cancio3, Gail Latlief4, Nicole Sasson5. 1. 1 Providence VA Medical Center, Rhode Island, Providence, RI, USA. 2. 2 The Department of Health Services, Policy, and Practice, Brown University, Providence, RI, USA. 3. 3 Extremity Trauma and Amputation Center of Excellence (EACE), Military Performance Laboratory, Center for the Intrepid, Brooke Army Medical Center, Fort Sam Houston, TX, USA. 4. 4 Regional Amputation Center, James A. Haley Veterans' Hospital, Tampa, FL, USA. 5. 5 Physical Medicine & Rehabilitation, VA NY Harbor Healthcare System and Department of Rehabilitation Medicine, New York University School of Medicine, New York, NY, USA.
Abstract
BACKGROUND: : Research on adaptation to advanced upper limb prostheses is needed. OBJECTIVES: : To (1) examine change in function, quality of life and community integration after prosthetic training, (2) determine whether change in outcomes varied by prosthesis complexity, and (3) compare patterns of change at 1 month for those who withdrew from the study and those who did not. STUDY DESIGN: : Quasi-experimental time series. METHODS: : Data were analyzed for 22 participants (18 completers). Performance and self-report outcome measures were collected after in-laboratory training (Part A) and every 4 weeks of home use (Part B). Outcomes from End of A to End of B were compared statistically. Outcomes across assessments and by configuration level were compared graphically. Changes in scores were compared graphically for completers and non-completers. RESULTS: : Quality of life scores did not change between End of A and End of B, whereas scores improved for one activity measure, two measures of self-reported function, and three dexterity measures ( p < 0.05). Outcomes of community integration, self-reported function, four dexterity measures, and one activity measure varied by prosthesis level. For participants who withdrew early, dexterity and activity scores worsened, perceived disability increased, and prosthesis satisfaction decreased after 4 weeks of home use. CONCLUSION: : Study completers adapted to the DEKA Arm. CLINICAL RELEVANCE: Findings suggest that for the majority of upper limb amputees discharged from prosthetic rehabilitation, function continues to improve with home use. However, a minority experience a decline in function, greater perceived disability, and greater dissatisfaction after 4 weeks, suggesting a need for continued therapy after intensive prosthetic training ends.
BACKGROUND: : Research on adaptation to advanced upper limb prostheses is needed. OBJECTIVES: : To (1) examine change in function, quality of life and community integration after prosthetic training, (2) determine whether change in outcomes varied by prosthesis complexity, and (3) compare patterns of change at 1 month for those who withdrew from the study and those who did not. STUDY DESIGN: : Quasi-experimental time series. METHODS: : Data were analyzed for 22 participants (18 completers). Performance and self-report outcome measures were collected after in-laboratory training (Part A) and every 4 weeks of home use (Part B). Outcomes from End of A to End of B were compared statistically. Outcomes across assessments and by configuration level were compared graphically. Changes in scores were compared graphically for completers and non-completers. RESULTS: : Quality of life scores did not change between End of A and End of B, whereas scores improved for one activity measure, two measures of self-reported function, and three dexterity measures ( p < 0.05). Outcomes of community integration, self-reported function, four dexterity measures, and one activity measure varied by prosthesis level. For participants who withdrew early, dexterity and activity scores worsened, perceived disability increased, and prosthesis satisfaction decreased after 4 weeks of home use. CONCLUSION: : Study completers adapted to the DEKA Arm. CLINICAL RELEVANCE: Findings suggest that for the majority of upper limb amputees discharged from prosthetic rehabilitation, function continues to improve with home use. However, a minority experience a decline in function, greater perceived disability, and greater dissatisfaction after 4 weeks, suggesting a need for continued therapy after intensive prosthetic training ends.
Authors: Linda J Resnik; Matthew L Borgia; Frantzy Acluche; Jill M Cancio; Gail Latlief; Nicole Sasson Journal: PLoS One Date: 2018-01-17 Impact factor: 3.240