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Understanding the Relationship Between Patient-Reported Function and Actual Function in the Upper Limb Prosthesis
Xuyuan Zhang1,2, Kerstin S Baun3, Lauren Trent3
1Center for Devices and Radiological Health, Office of Science and Engineering Labs, United States Food and Drug Administration, Silver Spring, MD.
Archives of Rehabilitation Research and Clinical Translation
|September 30, 2021
Summary
Patient-reported outcomes alone may not fully capture functional ability in upper limb prosthesis users. Performance-based measures are crucial for a comprehensive assessment of prosthetic function.
Area of Science:
- Rehabilitation Medicine
- Prosthetics and Orthotics
- Biomedical Engineering
Background:
- Functional assessment is key in upper limb prosthesis rehabilitation.
- Understanding the relationship between perceived and actual function is vital for optimizing outcomes.
- Current assessment methods may not fully capture user experience and performance.
Purpose of the Study:
- To investigate the correlation between self-reported functional ability and performance-based measures in individuals using upper limb prostheses.
- To determine if patient-reported outcomes adequately reflect functional performance at a specific stage of prosthetic rehabilitation.
- To identify potential discrepancies between perceived and actual functional capacity in prosthesis users.
Main Methods:
- Quantitative clinical descriptive study involving 61 participants with upper limb amputations using prosthetic devices.
- Utilized the Disabilities of the Arm, Shoulder, and Hand questionnaire (DASH) for patient-reported outcomes.
- Employed the Box and Blocks Test (BBT) and Capacity Assessment of Prosthesis Performance for the Upper Limb (CAPPFUL) for performance-based measures.
Main Results:
- Multiple linear regression models, controlling for prosthesis type and amputation level, found no significant association between DASH scores and BBT or CAPPFUL performance.
- Specific amputation levels (elbow, transhumeral, shoulder disarticulation) showed significant associations with functional performance.
- Hybrid prosthesis users demonstrated a significant negative association with CAPPFUL, while body-powered prosthesis users showed a positive association with BBT performance.
Conclusions:
- Patient-reported outcomes alone may not provide a comprehensive evaluation of functional ability in upper limb prosthesis users.
- Performance-based measures are essential complements to self-reported data for a complete functional assessment.
- Further research is needed to fully elucidate the relationship between subjective and objective functional measures in this population.
Keywords:
ADL, activities of daily livingAmputeesBBT, Box and Blocks TestCAPPFUL, Capacity Assessment of Prosthesis Performance for the Upper LimbDASH, Disabilities of the Arm, Shoulder, and Hand questionnaireOutcome assessment, health carePRO, patient-reported outcomePatient reported outcome measuresProsthesisRehabilitationUpper extremity
