Understanding the Relationship Between Patient-Reported Function and Actual Function in the Upper Limb Prosthesis User Population: A Preliminary Study

Abstract

Objective To understand how perceived function relates to actual function at a specific stage in the rehabilitation process for the population using upper limb prostheses. Design Quantitative clinical descriptive study. Setting Clinical offices. Participants A sample of 61 participants (N=61; mean age, 43.0±12.8y; 51 male/10 female) with upper limb amputation who use a prosthetic device and were in the definitive stage of a prosthesis fitting process. Interventions Not applicable. Main Outcome Measures A patient-reported outcome measure, the Disabilities of the Arm, Shoulder, and Hand questionnaire (DASH), and 2 performance-based outcome measures, Box and Blocks Test (BBT) and Capacity Assessment of Prosthesis Performance for the Upper Limb (CAPPFUL), were used as variables in multiple linear regression models. Results The multiple linear regression models, which controlled for prosthesis type and amputation level, did not show evidence that changes in the independent variable (DASH) are significantly associated with changes in the dependent variables (log(BBT) ( B =−0.007; 95% confidence interval [CI], −0.015 to 0.001; P =.0937) and CAPPFUL ( B =−0.083, 95% CI, −0.374 to 0.208; P =.5623)). In both models, individuals with elbow, transhumeral (above elbow), and shoulder disarticulation showed a significant negative association with the dependent variable (CAPPFUL or logBBT). In the CAPPFUL model, there was a significant negative association with individuals using a hybrid prosthesis ( B =−20.252; 95% CI, −36.562 to −3.942; P =.0170). In the logBBT model, there was a significant positive association with individuals using body-powered prostheses ( B =0.430; 95% CI, 0.089-0.771; P =.0157). Conclusions Although additional data and analyses are needed to more completely assess the association between self-reported measures and performance-based measures of functional abilities, these preliminary results indicate that patient-reported outcomes alone may not provide a complete assessment of an upper limb prosthesis users’ functional ability and should be accompanied by population-specific performance-based measures.

Deficient gait function despite effect index of the Western Ontario and McMaster university osteoarthritis index score considered cured one year after bilateral total knee arthroplasty

“…WOMAC scores may not fully capture limitations in patient gait performance as they are influenced by patient experience and confidence in their abilities [35,36]. Patients' perceptions of functional recovery after TKA may be influenced by functional difficulties and pain levels pre-TKA; thus, patients are more likely to overestimate their ability after TKA when pain levels are substantially reduced [37,38]. This study confirmed a significant positive correlation between pain and daily living function sub-items of the WOMAC score before and after TKA, consistent with other reports.…”