In a study published in Archives of Physical Medicine and Rehabilitation, researchers compared patient-reported outcomes of disability, activity difficulty, and the impact of health status on quality of life by prosthetic device use. The researchers concluded that people with upper-limb loss who did not use a prosthesis or used a cosmetic prosthesis reported more difficulty in activities and greater disability compared to those that use body-powered and myoelectric devices. Nonusers were more likely to need help with activities of daily living (ADLs) compared to those who used a body-powered prosthesis. The authors concluded that the findings highlight the clinical importance of encouraging prosthesis use.
Data was collected from a population-based sample of 755 veterans with unilateral upper-limb amputations who received care in through the US Department of Veterans Affairs from 2010 through 2015. Upper-limb-related disability was measured using the Disabilities of the Arm, Shoulder and Hand Score (QuickDASH). Health-related quality of life (HRQoL) was measured using the Veterans RAND 12 Item Health Survey (VR-12) Mental and Physical Component scores. Activity difficulty was assessed for one-handed and two-handed tasks, and by questions about the need for help with ADLs.
The research team found that the people who did not use a prosthesis had more difficulty performing one-handed tasks using the residual limb compared to those who used body-powered prostheses. Cosmetic device users had more task difficulty than body-powered and/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 had worse QuickDASH scores compared to body-powered users. In logistic regression modeling, the odds of needing ADL help were 1.84 times higher for nonusers compared to body-powered users.
The study, “Function and quality of life of unilateral major upper limb amputees: Impact of prosthesis use and type” was published in Archives of Physical Medicine and Rehabilitation.
