Resnik Linda, Fantini Christopher, Latlief Gail, Phillips Samuel, Sasson Nicole, Sepulveda Eve
Providence VA Medical Center, Providence, RI, United States of America.
Health Services, Policy and Practice, Brown University, Providence, RI, United States of America.
PLoS One. 2017 Jun 19;12(6):e0178642. doi: 10.1371/journal.pone.0178642. eCollection 2017.
Patients with upper limb amputation and brachial plexus injuries have high rates of prosthesis rejection. Study purpose is to describe experiences of subjects with transhumeral amputation and brachial plexus injury, who were fit with, and trained to use, a DEKA Arm.
This was a mixed-methods study utilizing qualitative (e.g. interview, survey) and quantitative data (e.g. self-report and performance measures). Subject 1, a current prosthesis user, had a shoulder arthrodesis. Subject 2, not a prosthesis user, had a subluxed shoulder. Both were trained in laboratory and participated in a trial of home use. Descriptive analyses of processes and outcomes were conducted.
Subject 1 was fitted with the transhumeral configuration (HC) DEKA Arm using a compression release stabilized socket. He had 12 hours of prosthetic training and participated in all home study activities. Subject 1 had improved dexterity and prosthetic satisfaction with the DEKA Arm and reported better quality of life (QOL) at the end of participation. Subject 2 was fit with the shoulder configuration (SC) DEKA Arm using a modified X-frame socket. He had 30 hours of training and participated in 3 weeks of home activities. He reported less functional disability at the end of training as compared to baseline, but encountered personal problems and exacerbation of PTSD symptoms and withdrew from home use portion at 3 weeks. Both subjects reported functional benefits from use, and expressed a desire to receive a DEKA Arm in the future.
This paper reported on two different strategies for prosthetic fitting and their outcomes. The advantages and limitations of each approach were discussed.
Use of both the HC and SC DEKA Arm for patients with TH amputation and brachial plexus injury was reported. Lessons learned may be instructive to clinicians considering prosthetic choices for future cases.
上肢截肢和臂丛神经损伤患者的假体排斥率很高。本研究的目的是描述经肱骨截肢和臂丛神经损伤患者使用DEKA义肢并接受相关训练的经历。
这是一项混合方法研究，采用定性（如访谈、调查）和定量数据（如自我报告和性能测量）。受试者1是一名现有的假体使用者，患有肩关节融合术。受试者2不是假体使用者，患有肩关节半脱位。两人均在实验室接受训练并参与了家庭使用试验。对过程和结果进行了描述性分析。
受试者1使用压缩释放稳定承窝，安装了经肱骨配置（HC）的DEKA义肢。他接受了12小时的假体训练，并参与了所有家庭研究活动。受试者1使用DEKA义肢后灵活性提高，假体满意度提高，并在参与结束时报告生活质量（QOL）有所改善。受试者2使用改良的X型框架承窝，安装了肩部配置（SC）的DEKA义肢。他接受了30小时的训练，并参与了3周的家庭活动。与基线相比，他在训练结束时报告功能残疾有所减轻，但遇到了个人问题，创伤后应激障碍（PTSD）症状加重，并在3周时退出了家庭使用部分。两名受试者均报告使用义肢有功能益处，并表示希望未来能获得DEKA义肢。
本文报告了两种不同的假体适配策略及其结果。讨论了每种方法的优缺点。
报告了将HC和SC DEKA义肢用于经肱骨截肢和臂丛神经损伤患者的情况。所吸取的经验教训可能对考虑为未来病例选择假体的临床医生具有指导意义。
