Zhang Xuyuan, Baun Kerstin S, Trent Lauren, Miguelez John, Kontson Kimberly
Center for Devices and Radiological Health, Office of Science and Engineering Labs, United States Food and Drug Administration, Silver Spring, MD.
School of Public Health, University of Maryland, College Park, MD.
Arch Rehabil Res Clin Transl. 2021 Jul 24;3(3):100148. doi: 10.1016/j.arrct.2021.100148. eCollection 2021 Sep.
To understand how perceived function relates to actual function at a specific stage in the rehabilitation process for the population using upper limb prostheses.
Quantitative clinical descriptive study.
Clinical offices.
A sample of 61 participants (N=61; mean age, 43.0±12.8y; 51 male/10 female) with upper limb amputation who use a prosthetic device and were in the definitive stage of a prosthesis fitting process.
Not applicable.
A patient-reported outcome measure, the Disabilities of the Arm, Shoulder, and Hand questionnaire (DASH), and 2 performance-based outcome measures, Box and Blocks Test (BBT) and Capacity Assessment of Prosthesis Performance for the Upper Limb (CAPPFUL), were used as variables in multiple linear regression models.
The multiple linear regression models, which controlled for prosthesis type and amputation level, did not show evidence that changes in the independent variable (DASH) are significantly associated with changes in the dependent variables (log(BBT) (=-0.007; 95% confidence interval [CI], -0.015 to 0.001; =.0937) and CAPPFUL (=-0.083, 95% CI, -0.374 to 0.208; =.5623)). In both models, individuals with elbow, transhumeral (above elbow), and shoulder disarticulation showed a significant negative association with the dependent variable (CAPPFUL or logBBT). In the CAPPFUL model, there was a significant negative association with individuals using a hybrid prosthesis (=-20.252; 95% CI, -36.562 to -3.942; =.0170). In the logBBT model, there was a significant positive association with individuals using body-powered prostheses (=0.430; 95% CI, 0.089-0.771; =.0157).
Although additional data and analyses are needed to more completely assess the association between self-reported measures and performance-based measures of functional abilities, these preliminary results indicate that patient-reported outcomes alone may not provide a complete assessment of an upper limb prosthesis users' functional ability and should be accompanied by population-specific performance-based measures.
了解在使用上肢假肢的人群康复过程的特定阶段，感知功能与实际功能之间的关系。
定量临床描述性研究。
临床办公室。
61名上肢截肢患者样本（N = 61；平均年龄43.0±12.8岁；51名男性/10名女性），他们使用假肢且处于假肢装配过程的确定阶段。
不适用。
采用患者报告结局指标——手臂、肩部和手部功能障碍问卷（DASH），以及2项基于表现的结局指标——箱块测试（BBT）和上肢假肢性能能力评估（CAPPFUL），作为多元线性回归模型中的变量。
在控制了假肢类型和截肢水平的多元线性回归模型中，没有证据表明自变量（DASH）的变化与因变量（log(BBT)（=-0.007；95%置信区间[CI]，-0.015至0.001；P =.0937）和CAPPFUL（=-0.083，95% CI，-0.374至0.208；P =.5623））的变化显著相关。在两个模型中，肘部、经肱骨（肘上）和肩关节离断的个体与因变量（CAPPFUL或logBBT）呈显著负相关。在CAPPFUL模型中，使用混合假肢的个体与因变量呈显著负相关（=-20.252；95% CI，-36.562至-3.942；P =.0170）。在logBBT模型中，使用体控假肢的个体与因变量呈显著正相关（=0.430；95% CI，0.089 - 0.771；P =.0157）。
尽管需要更多数据和分析来更全面地评估自我报告指标与基于表现的功能能力指标之间的关联，但这些初步结果表明，仅患者报告的结局可能无法全面评估上肢假肢使用者的功能能力，还应辅以针对特定人群的基于表现的指标。
