DO CHILDREN AND YOUNG ADULTS WITH UPPER LIMB REDUCTION DEFICIENCY PERFORM DIFFERENTLY?

Abstract

Since 1999 the arm prosthetics team of the Erasmus University Medical Center has been involved in development, validation and implementation of measures of functional status in children and adults with an upper limb reduction deficiency (ULRD) (1,5,6) Internationally now validated instruments such as the Prosthetic Upper Extremity Functional Index (PUFI) and Unilateral Below Elbow Test (UBET) are available (2,3,4) The clinical use of these measurement instruments and interpretation of the results is still a matter of discussion (7,8) We do not yet understand why patients choose to wear or not to wear arm prostheses, nor can we predict the amount and pattern of use. From previous research we know that both wearers and non-wearers perform well in activities of daily life. Still 30-50% of the patients with ULRD do choose to wear an arm prosthesis. Arm prostheses seem to have functional merits for specific activities. In addition they are likely to have a considerable personal function, in which self-esteem and cosmetics play important roles as well. The importance and influence of these aspects have not yet been evaluated. No longitudinal cohort studies or intervention studies have been done until now, so we do not yet know how capacity of prosthetic use and performance in daily life change with age. Assessing aspects of functioning on the different ICF levels and searching for relationships among them may lead to better understanding of the functionality of arm prostheses and the performance of patients with ULRD. In this paper we will explore whether age might be a relevant factor for functioning with or without a prosthesis. The first purpose is to compare two age groups regarding capacity and performance of functional activities with or without prosthesis, measured by the PUFI and UBET (2,3,4) The second purpose is to get further insight in clinical usefulness of these instruments.