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Evaluation of functionality in acquired and congenital upper extremity child amputees
Mustafa Korkmaz1, Fatih Erbahçeci, Ozlem Ulger
1Sevgican Special Training and Rehabilitation Center, Ankara, Turkey.
Insights
Children with congenital upper limb loss achieved better functional outcomes post-rehabilitation than acquired amputees. Higher prosthesis use correlated with improved functionality in upper limb amputees.
Area of Science:
- Pediatric rehabilitation
- Prosthetics and orthotics
- Functional outcomes assessment
Background:
- Children with upper limb loss require tailored rehabilitation programs.
- Congenital and acquired amputations present distinct challenges in prosthetic use and functional adaptation.
- Evaluating functional levels is crucial for optimizing prosthetic interventions in pediatric amputees.
Purpose of the Study:
- To assess the functional status of children with congenital and acquired upper limb loss following a structured rehabilitation program.
- To compare the functional outcomes between congenital and acquired upper limb amputee groups.
- To identify factors influencing functional levels in pediatric upper limb amputees.
Main Methods:
- A cohort of 40 children (8-17 years) with upper limb loss was divided into congenital (n=20) and acquired (n=20) groups.
- Participants underwent prosthetic fitting, training, and rehabilitation.
- Functional status was evaluated using the Child Amputee Prosthetics Project - Functional Status Inventory (CAPP-FSI) and Prosthetic Upper Extremity Functional Index (PUFI) at baseline, 3 weeks, and 6 months post-discharge, with and without prosthesis.
Main Results:
- Significant differences in functional scores were observed between congenital and acquired groups across all measurement points (p<0.05).
- The congenital group consistently demonstrated higher CAPP-FSI and PUFI scores compared to the acquired group (p<0.05).
- Congenital amputees reported higher daily prosthesis usage (8 hours) than acquired amputees (4-8 hours).
Conclusions:
- Daily prosthesis usage duration and engagement in daily activities significantly determine functional levels in pediatric upper limb amputees.
- Rehabilitation programs should emphasize maximizing prosthesis use to enhance functional outcomes.
- Individualized approaches considering the type of limb loss are essential for pediatric prosthetic rehabilitation.
Objective:
The aim of this study was to evaluate the functional level of children with congenital and acquired upper limb loss after a rehabilitation program.
Methods:
This study included a total of 40 children, aged 8 to 17 years with upper limb loss. Children were divided into two groups; congenital amputees (n=20) and acquired amputees (n=20). The children underwent prosthetic fitting, prosthetic training and rehabilitation. The Child Amputee Prosthetics Project - Functional Status Inventory (CAPP-FSI) and Prosthetic Upper Extremity Functional Index (PUFI) were used at the initial visit to the prosthetic unit without prosthesis, 3 weeks after the prosthetic training and 6 months after discharge with and without prosthesis. The results with and without the prosthesis were compared between the acquired and congenital amputee groups.
Results:
There were significant differences in all tests performed at the baseline, at the 3rd week, and at the 6th month without prosthesis and at the 3rd week and at the 6th month with prosthesis (p<0.05). The congenital group received higher scores in the CAPP-FSI and PUFI at the baseline, at the 3rd week and at the 6th month (p<0.05). Patients in the congenital group used their prostheses for 8 hours a day and the acquired group for 4 to 8 hours.
Conclusion:
Daily prosthesis usage time and the child's experience with the prosthesis during daily activities are the determining factors for the functional level in upper limb child amputees. Functionality may improve based on these factors.
