Related Experiment Video
Updated: Jun 24, 2026
A Structured Rehabilitation Protocol for Improved Multifunctional Prosthetic Control: A Case Study
Published on: November 6, 2015
Functional outcome measures for pediatric upper limb deficiencies with and without prostheses: A systematic review
Holly Cordray1, Miguel Fiandeiro1, Manisha Banala1
1Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
Insights
No single outcome measure perfectly assesses pediatric upper limb deficiencies (ULDs). The Assisting Hand Assessment and Assessment of Capacity for Myoelectric Control show promise for observational assessment, while the Child Amputee Prosthetics Project-Functional Status Inventory is a provisional recommendation for questionnaires.
Area of Science:
- Orthopedics and Rehabilitation
- Pediatric Health
- Prosthetics and Assistive Devices
Background:
- Effective orthopedic care for pediatric upper limb deficiencies (ULDs) necessitates reliable outcome measures to track functional progress and prosthetic control during child development.
- Current assessment tools may not adequately capture the nuances of functional abilities and prosthetic integration in children with ULDs.
Purpose of the Study:
- To systematically review and critically appraise existing instruments for assessing upper limb function in children with ULDs.
- To identify the most psychometrically sound and feasible outcome measures for use in clinical practice and research settings.
Main Methods:
- A systematic literature search was conducted across PubMed, Embase, CINAHL, and Scopus, adhering to PRISMA guidelines.
- Studies evaluating instrument validity, reliability, and responsiveness in children (<18 years) with ULDs were included.
- Multiple reviewers independently screened studies, extracted data, assessed risk of bias, and rated psychometric properties using the COSMIN methodology.
Main Results:
- Nineteen reports describing 4 performance-based tests and 6 patient-reported outcome measures were included.
- No single ideal outcome measure currently exists for pediatric ULDs.
- The Assessment of Capacity for Myoelectric Control and Assisting Hand Assessment demonstrate the best feasibility and psychometrics for standardized observational assessment, particularly for myoelectric prostheses.
- The Child Amputee Prosthetics Project-Functional Status Inventory is provisionally recommended as a parent-reported questionnaire, though revisions and reliability studies are needed.
Conclusions:
- Existing outcome measures for pediatric ULDs require further development and validation.
- The Assisting Hand Assessment and Assessment of Capacity for Myoelectric Control are the most promising observational tools.
- Further research is needed to refine and validate parent-reported questionnaires for broader clinical implementation.
Abstract:
Effective orthopedic care/rehabilitation for pediatric upper limb deficiencies (ULDs) requires understanding how function and prosthetic control progress as the child develops. Psychometrically sound outcome measures are imperative. This systematic review critically appraised the instruments available for assessing upper limb function among children with ULDs. PubMed, Embase, CINAHL, and Scopus were searched. Eligible studies evaluated instruments' validity, reliability, and/or responsiveness and included children under 18 years. Following PRISMA guidelines, multiple reviewers independently screened studies, extracted data, assessed risk of bias, and rated psychometrics and evidence quality by the COnsensus-based Standards for selection of health Measurement INstruments methodology. Reviewers screened 2513 studies; 19 reports describing 4 performance-based tests and 6 patient-reported outcome measures were included. An ideal outcome measure for pediatric ULDs does not yet exist. For clinicians/researchers seeking a standardized observational assessment, the Assessment of Capacity for Myoelectric Control (valid only for myoelectric prostheses) and Assisting Hand Assessment are the most promising options, showing the best feasibility and psychometrics. A modified Assisting Hand Assessment is under development for ULDs with or without prosthesis use. For clinicians/researchers seeking a more practical questionnaire that they can implement beyond the clinic, all existing options would benefit from revision and simplification. We provisionally recommend the 10-min, parent-reported Child Amputee Prosthetics Project-Functional Status Inventory. However, the preschooler version needs construct revisions, and all versions need reliability studies. Two well-known pediatric instruments, the Patient-Reported Outcomes Measurement Information System and Pediatric Outcomes Data Collection Instrument, are invalid for assessing upper limb function among patients with ULDs.
More Related Videos
Related Concept Videos
01:27Fractures: Bone Repair
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the procedure...
01:08Reflex Activity
A reflex exam is a diagnostic procedure performed by a healthcare professional to evaluate the functionality of a patient's...