Research Department, Providence VA Medical Center, Providence, RI, USA.
Health Services, Policy and Practice, Brown University, Providence, RI, USA.
Disabil Rehabil. 2022 Jun;44(11):2470-2481. doi: 10.1080/09638288.2020.1829106. Epub 2020 Oct 18.
To present population data on standardized measures of dexterity, activity performance, disability, health-related quality of life (HRQoL) and community integration for persons with upper limb amputation (ULA), compare outcomes to normative values, and examine differences by prosthesis type and laterality (unilateral vs. bilateral amputation).
Multi-site, cross-sectional design, with in-person evaluations, functional performance, and self-report measures. Descriptive and comparative analyses were performed by amputation level and prosthesis type, data were compared for unilateral and bilateral amputation.
One hundred and twenty-seven individuals participated; mean age 57 years, 59% percent body-powered prostheses users. All measures of dexterity differed ( < 0.05) by amputation level and by laterality. All measures of activity differed by amputation level with the best scores in transradial (TR) amputation groups. Comparisons of body-powered users with TR amputation found that dexterity was better for those with bilateral compared to unilateral amputation.
Dexterity is markedly impaired in persons with ULA. Individuals with more proximal ULA levels are most impacted. HRQoL and community participation are less impacted and more equivalent to unimpaired persons. Further research is needed to examine differences by terminal device type and determine how best to match persons with ULA to the optimal prosthesis type and componentry, based on individual characteristics.Implications for RehabilitationThis study provides population-based, comparative data on dexterity, activity performance, disability, quality of life, and independence in upper limb prosthesis users.The study provides preliminary analyses comparing the effectiveness of body-powered devices, myoelectric devices with single degree of freedom and multi-degree of freedom terminal devices.The data presented in this study can be used to benchmark outcomes in patients who are upper limb prosthesis users.The data will also be useful to inform comparative evaluations of existing and emerging prosthetic technology.
介绍上肢截肢者(ULA)在灵巧度、活动表现、残疾、健康相关生活质量(HRQoL)和社区融合的标准化衡量指标方面的人群数据,将结果与正常值进行比较,并检查假肢类型和侧别(单侧与双侧截肢)的差异。
多地点、横断面设计,包括面对面评估、功能表现和自我报告措施。根据截肢水平和假肢类型进行描述性和对比分析,比较单侧和双侧截肢的数据。
共有 127 人参与;平均年龄 57 岁,59%为动力型假肢使用者。所有灵巧度指标均根据截肢水平和侧别存在差异( < 0.05)。所有活动指标均根据截肢水平存在差异,其中桡骨截断(TR)截肢组的得分最高。与 TR 截肢的动力型假肢使用者进行比较,发现双侧截肢者的灵巧度优于单侧截肢者。
上肢截肢者的灵巧度明显受损。截肢水平越高,受到的影响越大。HRQoL 和社区参与度受影响较小,与未受损者更为接近。需要进一步研究终端设备类型的差异,并根据个体特征确定如何根据最佳假体类型和组件为 ULA 患者匹配最合适的假体。
本研究提供了上肢假体使用者灵巧度、活动表现、残疾、生活质量和独立性的基于人群、具有可比性的数据。
本研究初步分析了动力型装置、单自由度和多自由度终端装置的肌电假肢的效果。
本研究中提供的数据可用于基准上肢假体使用者的结果。
这些数据也将有助于为现有和新兴假肢技术的比较评估提供信息。