Browsing by Author "Roebroeck, Marij E."

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    DO CHILDREN AND YOUNG ADULTS WITH UPPER LIMB REDUCTION DEFICIENCY PERFORM DIFFERENTLY?
    (2008) Pesch-Batenburg, Josemiek M.F.B.; Buffart, Laurien M.; van Markus-Doornbosch, Frederieke; Stam, Henk J.; Roebroeck, Marij E.
    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.
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    FUNCTIONAL STATUS OF CHILDREN WITH A CONGENITAL UPPER LIMB REDUCTION DEFICIENCY
    (2005) Buffart, Laurien M.; Pesch-Batenburg, Josemiek M.F.B.; van Heijningen, Vera G.; Roebroeck, Marij E.; Stam, Henk J.
    Congenital reduction deficiencies of the upper limb are rare. Nearly 50% of children with unilateral transverse upper limb reduction deficiencies (ULRD) wear a prosthetic device to enhance the ability to perform functional activities. Unfortunately, empirical evidence as to whether prostheses yield improved functional outcomes in these children is lacking. Assessment of arm and prosthetic functioning mostly relies on clinical observation of task performance. The purpose of this study was to assess the functional status of children with ULRD as measured by these standardized instruments. To adequately measure arm and prosthetic functioning in children with ULRD, standardized measures at activity level are required. The difference between what a child “can do” in a clinical setting and “does do” in daily life is well known, also recognized as capacity and performance of activities [1]. Therefore both aspects should be measured. Capacity can be measured with functional tests and to measure performance of activities, assessment of spontaneous arm use or self-reported or parent-reported questionnaires are options.
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    VALIDITY AND RELIABILITY OF FUNCTIONAL TESTS AND QUESTIONNAIRES FOR CHILDREN WITH A CONGENITAL UPPER LIMB REDUCTION DEFICIENCY
    (2005) Buffart, Laurien M.; Roebroeck, Marij E.; van Heijningen, Vera G.; Pesch-Batenburg, Josemiek M.F.B.; Stam, Henk J.
    Standardized measures are required to adequately measure arm and prosthetic functioning in children with unilateral upper limb reduction deficiency (ULRD). A prerequisite for a test or questionnaire is that the instrument has to actually measure what it is supposed to measure, also referred to as validity. With respect to validity, functional tests and questionnaires that are able to measure arm or prosthetic functioning were selected according to the following criteria: (i) they had to be attractive for children aged 4 to 12, (ii) they had to represent bimanual activities and (iii) they had to score quality of movement (functional tests) and/or difficulty (questionnaires) [1]. According to these criteria, we selected two functional tests, the Assisting Hand Assessment (AHA) [2] and the Unilateral Below Elbow Test (UBET) [3, 4] and two questionnaires, the Prosthetic Upper extremity Functional Index (PUFI) [5, 6] and ABILHAND-Kids [7]. In the present study we make a head-to-head comparison of these instruments to judge their clinical usefulness and to identify the best functional test and the best questionnaire for children with ULRD.