Research Department, Providence VA Medical Center, Providence, Rhode Island; Health Services, Policy and Practice, Brown University, Providence, Rhode Island.
Research Department, Providence VA Medical Center, Providence, Rhode Island.
Arch Phys Med Rehabil. 2020 Aug;101(8):1396-1406. doi: 10.1016/j.apmr.2020.04.003. Epub 2020 May 11.
To compare patient-reported outcomes of disability, activity difficulty, and health-related quality of life (HRQOL) by prosthetic device use and configuration and to identify factors associated with these outcomes.
Telephone survey.
General community.
Population-based sample of veterans (N=755) with unilateral upper limb amputation recruited from a national sample of veterans with upper limb amputation who received care at the Veterans Affairs clinic from 2010-2015.
Not applicable.
Upper limb-related disability was measured using Disabilities of the Arm, Shoulder, and Hand score (QuickDASH). HRQOL was measured using the Veterans RAND 12-item Health Survey Mental and Physical Component scores. Activity difficulty was assessed for 1-handed and 2-handed tasks and by questions about the need for help with activities of daily living (ADLs).
Patients who did not use a prosthesis had more difficulty performing 1-handed tasks using the residual limb as compared with those who used body-powered prostheses. Cosmetic device users had more task difficulty than body-powered or myoelectric users. Linear regression models did not show an association between type of prosthesis used and HRQOL scores, but did show that those who did not use a prosthesis (non-users) had worse QuickDASH scores (β=9.4; P=.0004) compared to body-powered users. In logistic regression modeling, the odds of needing help with ADLs were 1.84 times higher (95% confidence interval, 1.16-2.92) for non-users compared with body-powered users.
Amputees who did not use a prosthesis or used a cosmetic prosthesis reported more difficulty in activities and greater disability as compared with those who use body-powered and myoelectric devices. Non-users were more likely to need help with ADLs as compared with those who used a body-powered prosthesis. Our findings highlight the clinical importance of encouraging prosthesis use. Further research is needed to compare physical performance by prosthesis configuration.
比较使用和配置假肢对残疾、活动困难和健康相关生活质量（HRQOL）的患者报告结果，并确定与这些结果相关的因素。
电话调查。
一般社区。
从 2010-2015 年在退伍军人事务诊所接受上肢截肢治疗的上肢截肢退伍军人全国样本中招募的单侧上肢截肢的基于人群的样本（N=755）。
不适用。
上肢相关残疾使用手臂、肩部和手残疾量表（QuickDASH）进行测量。HRQOL 使用退伍军人 RAND 12 项健康调查精神和身体成分评分进行测量。使用单手和双手任务以及有关日常生活活动（ADL）需要帮助的问题评估活动难度。
与使用身体动力假肢的患者相比，不使用假肢的患者使用残肢进行单手任务时更困难。美容设备使用者的任务难度大于身体动力或机电设备使用者。线性回归模型显示使用的假肢类型与 HRQOL 评分之间没有关联，但确实表明未使用假肢（非使用者）的患者的 QuickDASH 评分较差（β=9.4；P=.0004）与身体动力使用者相比。在逻辑回归模型中，与身体动力使用者相比，非使用者需要帮助 ADL 的可能性高 1.84 倍（95%置信区间，1.16-2.92）。
与使用身体动力和机电设备的患者相比，不使用假肢或使用美容假肢的截肢患者在活动中报告更多困难，残疾程度更高。与使用身体动力假肢的患者相比，非使用者更有可能需要帮助进行 ADL。我们的研究结果强调了鼓励使用假肢的临床重要性。需要进一步研究比较假肢配置的身体表现。
