LAS VEGAS – There are unique differences in the subjective responses between patients with limb differences at the partial hand level, according to a presenter at the 2011 American Orthotic & Prosthetic Association National Assembly, here. Karl J. Lindborg, CPO, OT, FISPO, presented the results of an 18-month retrospective study of partial hand amputees using i-limb digits (Touch Bionics).
Lindborg and his team aimed to create a valid reliable instrument with interrelated reliability for domains such as lifestyle, which included patient perception before and after prosthetic fitting, as well as comfort in public, occupational and social settings. Pain issues, quality of life, activities of daily living skill level and recreational activities were among the other factors evaluated. Lindborg said there was an emphasis on patient success, utilization and satisfaction.
“A good outcome was not what clinicians define objectively but what the patient perceived for himself as it relates to skill, confidence and concentration,” he said.
The study enrolled 14 patient with partial hand loss – 11 secondary to trauma, disease or infection and 3 secondary to congential limb deficiency. There was a 3-month minimum time with the i-limb digits. Patients completed a follow-up assessments with more than 100 data points. Emphasis was on the user’s perception of improved self image, increased activity, ability versus perception, pain and overuse, and positive change in lifestyle. Patients received extensive integration of occupational therapy throughout the process.
Lindborg said at baseline, patients with congential limb differences at partial hand level viewed themselves as completely independent. However, at follow-up they viewed themselves as feeling increased independence and improved self-image. This patient population reported feeling greater potential for success and overall feeling more comfortable, he said.
Unilateral and bilateral partial hand amputees who had lost hands secondary to traumatic injury or disease had similar objective responses in areas of overall well-being and independence subjective responses, but Lindborg said the responses were different from the congential population. Responses included, “It gave me my confidence in a way that I can live going forward,” “I can now shake hands as I did before with people looking at ‘me’ and not part of my hand.”
“Individuals with bilateral partial hand loss were impacted most by i-limb digits as it related to increased activity and participation in life,” he said.
Lindborg K. An 18-month retrospective look at partial hand patients using a prosthetic hand. Presented at the 2011 American Orthotic & Prosthetic Association National Assembly. Sept. 19-22. Las Vegas.
