School of Pharmacy and Health Professions, Creighton University, Omaha, NE, USA.
Department of Biomechanics, University of Nebraska at Omaha, Omaha, NE, USA.
Sci Rep. 2022 May 6;12(1):7447. doi: 10.1038/s41598-022-11470-8.
Current training interventions assessing pediatric functional motor skills do not account for children and adolescents with upper limb reductions who utilize a prosthesis. Prosthesis rejection showed that 1 out of 5 prosthesis users will reject their prosthesis due to lack of durability, lack of function, not meeting the participant's needs, perceived lack of need, and medical restrictions indicating that prosthetic users believed they were more functional without the device. It was hypothesized that an 8-week Home Intervention program will result in significant improvements in gross manual dexterity, bimanual coordination, and the functional activities performed during the program. It was also hypothesized that the novel Prosthesis Measurement of Independent Function (PMIF) score will reflect the Home Intervention performance improvements. Five pediatric participants (ages 5-19 years) with congenital upper limb reductions were fitted with a 3D printed upper extremity prosthesis for their affected limb. Participants then completed the 8-week Home Intervention which included Training activities completed 2×/week for 8 weeks and Non-Training activities completed only at week 1 and week 8. Participant's times were recorded along with each participant receiving a PMIF score ranging from 0 = unable to complete activity, to 7 = complete independence with activity completion. Results showed a decrease in overall averaged activity times amongst all activities. For all activities performed, individual averaged time decreased with the exception of Ball Play which increased over the 8-week intervention period. There was significant interaction for Home Intervention performance with F = 2.904 (p = 0.003). All participants increased their PMIF scores to 7 (complete independence) at the end of the 8 week intervention period. Decreases in time averages and increases in PMIF scores indicate that learning and functional use of the prostheses have occurred amongst the pediatric participants.
目前评估儿童功能性运动技能的培训干预措施并未考虑到使用假肢的上肢截肢儿童和青少年。假肢排斥表明，每 5 名假肢使用者中就有 1 名会因耐用性差、功能不足、不符合参与者需求、感知缺乏需求以及医疗限制而拒绝使用假肢，这些限制表明假肢使用者认为他们在没有设备的情况下更具功能性。研究假设为期 8 周的家庭干预计划将导致粗大运动灵巧性、双手协调能力以及在计划期间进行的功能性活动显著改善。还假设新颖的假肢独立功能测量（PMIF）评分将反映家庭干预的表现改善。5 名患有先天性上肢缺失的儿科参与者（年龄 5-19 岁）为其患病肢体配备了 3D 打印上肢假肢。然后，参与者完成了为期 8 周的家庭干预，其中包括每周完成 2 次的训练活动和仅在第 1 周和第 8 周完成的非训练活动。记录了参与者的时间，每位参与者都获得了从 0（无法完成活动）到 7（独立完成活动）的 PMIF 评分。结果显示，所有活动的总平均用时均有所减少。对于所有进行的活动，除了球戏外，个体平均用时均减少，而球戏在 8 周干预期间增加。家庭干预表现的 F 值存在显著交互作用（F=2.904，p=0.003）。所有参与者在 8 周干预结束时将 PMIF 评分提高到 7（完全独立）。平均用时的减少和 PMIF 评分的增加表明，儿科参与者已经学习并能够功能性地使用假肢。
