In a recent study, a research team presented population data on standardized measures of dexterity, activity performance, disability, health-related quality of life (HRQoL), and community integration for people with upper-limb amputations, compared outcomes to normative values, and examined differences by prosthesis type and laterality (unilateral versus bilateral amputations).
The researchers concluded that dexterity is markedly impaired in people with upper-limb amputations and that individuals with more proximal residual limb levels are most impacted. HRQoL and community participation are less impacted and more equivalent to people without amputations. The study authors noted that dexterity was significantly better for those who had bilateral amputations as compared to those who had unilateral amputations, which they say suggests that increased prosthesis engagement among persons with bilateral amputation, results in better prosthetic function. Persons with bilateral amputation, however, did have worse scores on measures of performance in activities of daily living.
The multisite, cross-sectional design included in-person evaluations by physical or occupational therapists, assisted by a research coordinator; functional performance; and self-report measures. Descriptive and comparative analyses were performed by amputation level and prosthesis type, and data was compared for unilateral and bilateral amputation.
One hundred and twenty-seven individuals who used an active prosthesis participated (body-powered, myoelectric, hybrid, or Luke Arm); their mean age was 57 years, and 59 percent used body-powered prostheses. All measures of dexterity, the Jebsen Taylor Hand Function test, Box and Blocks test, Nine Hole Peg, and Southampton Assessment Procedure, differed by amputation level and by laterality.
All measures of activity differed by amputation level with the best scores in transradial amputation groups. Comparisons of body-powered users with transradial amputation found that dexterity was better for those with bilateral amputations compared to those with unilateral amputations.
The researchers failed to find statistically significant differences in dexterity or activity performance by prosthesis type, stating that further research is needed to examine differences by terminal device type and determine how best to match persons with upper-limb amputations to the optimal prosthesis type and componentry. However, the data presented in this study can be used to benchmark outcomes in patients who are upper-limb prosthesis users.
The open-access study, Dexterity, activity performance, disability, quality of life, and independence in upper limb Veteran prosthesis users: a normative study, was published in Disability and Rehabilitation.