Resnik Linda, Acluche Frantzy, Borgia Matthew, Cancio Jill, Latlief Gail, Sasson Nicole
1 Providence VA Medical Center, Rhode Island, Providence, RI, USA.
2 The Department of Health Services, Policy, and Practice, Brown University, Providence, RI, USA.
Prosthet Orthot Int. 2018 Dec;42(6):571-582. doi: 10.1177/0309364618774054. Epub 2018 May 19.
: Research on adaptation to advanced upper limb prostheses is needed.
: 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.
: Quasi-experimental time series.
: 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.
: 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.
: Study completers adapted to the DEKA Arm.
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.
需要对适应先进上肢假肢进行研究。
（1）检查假肢训练后功能、生活质量和社区融入情况的变化；（2）确定结果变化是否因假肢复杂性而异；（3）比较退出研究的参与者和未退出研究的参与者在1个月时的变化模式。
准实验性时间序列。
对22名参与者（18名完成者）的数据进行分析。在实验室训练后（A部分）以及在家使用的每4周（B部分）收集性能和自我报告的结果测量数据。对从A结束到B结束的结果进行统计学比较。通过图表比较不同评估和不同配置水平的结果。对完成者和未完成者的分数变化进行图表比较。
生活质量得分在A结束和B结束之间没有变化，而一项活动测量、两项自我报告功能测量和三项灵巧性测量的得分有所提高（p < 0.05）。社区融入、自我报告功能、四项灵巧性测量和一项活动测量的结果因假肢水平而异。对于提前退出的参与者，在家使用4周后，灵巧性和活动得分恶化，感知到的残疾增加，对假肢的满意度下降。
研究完成者适应了DEKA手臂。
研究结果表明，对于大多数从假肢康复出院的上肢截肢者来说，在家使用时功能会持续改善。然而，少数人在4周后功能下降、感知到的残疾增加且不满程度更高，这表明在强化假肢训练结束后需要继续进行治疗。
