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Published on: January 11, 2016
Use and functioning of the affected limb in children with unilateral congenital below-elbow deficiency during infancy
Mijna Hadders-Algra1, Heleen A Reinders-Messelink, Karin Huizing
1Dept. of Paediatrics-Developmental Neurology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Insights
Children with unilateral congenital below elbow deficiency (UCBED) effectively use their affected limb for daily activities and play. Prosthetic use may hinder performance, while neurological function is generally normal.
Area of Science:
- Pediatric rehabilitation
- Developmental pediatrics
- Limb difference research
Background:
- Children with unilateral congenital below elbow deficiency (UCBED) have functional limitations.
- Limited understanding exists regarding daily activity performance, prosthesis use, and neurological status in very young children with UCBED.
Purpose of the Study:
- To investigate daily activities, affected limb usage (with/without prosthesis), and neurological condition over time in young children with UCBED.
Main Methods:
- Longitudinal observational multiple case study design.
- Four children with UCBED were assessed from 3-16 months, with follow-ups up to 49 months.
- Utilized video-recorded play sessions, neurological examinations, and the PEDI-NL for functional assessment.
Main Results:
- Children with UCBED demonstrated efficient use of their affected limb during spontaneous play.
- Prosthesis use was associated with decreased manipulation, exploration, variation, and adaptation.
- Three children exhibited minor neurological dysfunction, with overall daily functioning comparable to the norm population.
Conclusions:
- The affected limb in children with UCBED serves as a crucial tool for exploration, manipulation, and fixation from infancy.
- Normal daily life functioning in these children highlights the limb's value.
- Prosthetic use might result in less effective performance.
Background:
Children with unilateral congenital below elbow deficiency (UCBED) lack a part of an arm, thereby lacking a part of the typical hand function. Little is known on the performance of daily activities in very young children with UCBED, usage of their affected arm with or without prosthesis during play, and neurological condition.
Aim:
To explore daily activities, the use of the affected limb with or without prosthesis and neurological condition over time in young children with UCBED.
Design:
A longitudinal observational multiple case study.
Methods:
Four children with UCBED were assessed (first assessment at 3-16months) every 6-8months (follow-up 13-49months) with a video-recorded, standardized play session and a neurological examination. Yearly, functioning in daily activities was evaluated using the Pediatric Evaluation of Disability Inventory - Dutch Version (PEDI-NL). Play behaviour was assessed with and without prosthesis, where applicable (n=2). Video-analysis focused on achievement, exploration, variation and adaptability of the affected limb. Behavioural changes over time were plotted and analysed visually.
Results:
Over time, children with UCBED showed efficient usage of their affected arm during spontaneous play. Prosthesis use seemed to be associated with reduced manipulation, exploration, variation and adaptation. Three children showed minor neurological dysfunction. Functioning in daily activities was comparable to a norm population.
Conclusion:
The short limb of children with UCBED is used as an exploratory, manipulatory and fixating tool from the beginning of infancy. Its value seems to be reflected in these children's normal functioning in daily life. Prosthetic use may lead to less effective performance.
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