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Updated: Oct 18, 2025

Therapy Interventions for Upper Limb Amputees Undergoing Selective Nerve Transfers
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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
PubMed
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.

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

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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.