Regarding Upper Extremity Prosthesis Use and Issues Among Wisconsin AgrAbility Clients Presented by Richard J Straub PhD Project Leader University of WisconsinMadison Biological Systems Engineering Department ID: 375110
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Pilot Survey Results Regarding Upper Extremity Prosthesis Use and Issues Among Wisconsin AgrAbility Clients.
Presented by:
Richard J. Straub, PhD Project Leader
University of Wisconsin-Madison, Biological Systems Engineering Department.
AgrAbility of Wisconsin. Slide2
Contributors
University of Wisconsin – Madison
Occupational Therapy Program, Department of Kinesiology
Joshua J. Hedrich, MSOT
Dorothy F. Edwards, PhD
Medstar Health Systems – National Rehabilitation Hospital, Washington, D.C
.
Rahsaan J. Holley, MS, OTR
Alexander W. Dromerick, MD
University of Wisconsin-Madison,
Biological Systems Engineering Department/AgrAbility of Wisconsin
Robert H. Meyer, MS
Richard J. Straub, PhDSlide3
BackgroundAgrAbility of Wisconsin was approached in the Fall of 2009 to assist with a survey related to upper extremity amputation and prosthetic training.
The investigators were interested in any differences between rural and urban populations.Slide4
Project purpose and participantsTo explore the effects of:
upper extremity prosthesis use, and
prosthetic training on the functional ability of individuals with an upper extremity amputation
74 clients (past and current) of the AgrAbility of Wisconsin program.Slide5
Survey Basics
Self-report mail based survey:
Characteristics of participants
Location and etiology of amputation, prosthesis type, use and frequency
Self-efficacy in prosthesis use and common activities.
Training involved in learning to use prosthesis
DASH (Disabilities of the Arm, Shoulder and Hand)
Standardized, valid survey instrument (30 items)
Demographic and employment questionsSlide6
MethodsSurvey packets were provided to AgrAbility of Wisconsin.
Survey, introduction letter and reply postage paid envelope (returned directly to UW Survey Center)
AgrAbility of Wisconsin inserted a personalized letter describing the purpose and informing the clients of their rights under our UW-Extension IRB guidelines.
No follow up procedures or incentives were used. Participants were informed in the AAW letter that this was a one-time survey mailing.Slide7
ResultsTotal number of surveys mailed out: 74
Completed surveys returned: 20 (1 was returned incomplete)
Response rate 27%Slide8
Demographics
19 male, 1 female
Mean age 54 (S.D. 11.7) Range 34 – 82
Amputation level
Partial hand - 7
Wrist disarticulation - 3
Below elbow - 4
At elbow - 1
Below shoulder - 3
At shoulder - 3Slide9
Etiology of Amputations19 civilian related trauma (9 specifically listed farm accident as cause)
1 birth related defect
Timeframe:
2000 - 2009 - 5 amputations
1990 -
1999
- 7 amputationsSlide10
Prosthetic Use
12 individuals indicated current or prior use of a device:
Cosmetic - 4
Body powered - 9
Externally powered - 2
Hybrid - 1
Number of days used in last month:
0 days - 2
1 - 10 days - 2
At least 28 days - 7
Did not indicate - 1
Length of
time
per day
used in previous week:
0 - 3 hours - 1 individual
7 to 9 hours - 3 individuals
10 + hours - 4 individuals
Did not indicate - 4 individuals
*note some clients reported use of more than 1 type of device.Slide11
Ability to use prosthesis in certain activities:
Activity
Able to use
Not able (want to)
Write
1
10 (4)
Turn a key
3
8 (3)
Prepare a meal
7
4 (1)
Place an object on a shelf, overhead
5
6 (3)
Heavy household chores
6
5 (1)
Make a bed
8
3 (1)
Carry a shopping bag
10
1 (1)
Carry a heavy object
8
3 (3)Slide12
Ability to perform tasks, continued…
Change lightbulb overhead
1
10 (4)
Wash/blowdry hair
5
6 (2)
Put on pullover sweater
6
5 (1)
Use knife to cut food
4
7 (3)
Recreation low effort (cards, knit)
7
3 (2)
Recreation some arm force (golf, hammer)
5
6 (5)
Recreation with free arm movement (frisbee)
3
7 (4)Slide13
Client Responses
Holding objects during activity, including holding nails to hammer, holding string to tie knot or shoes, holding book or papers
Meal preparation activities, includes using a knife, peeling vegetables
Carrying objects
Operating vehicle/farm equipment/power tools
Using manual labor tools, including shovels, forks, scrapersSlide14
DiscussionParticipants reported some degree of success with prostheses
Some areas from the previous table indicate a desire to perform a task
Writing, overhead tasks, recreation
Small sample size limits conclusions, this is informational, pilot data only.Slide15
Discussion, Cont.Why did those individuals who said they received training score higher on the disability level?
Possibly the extent of the amputation -- those with the greatest amputation were offered more training.
Participants may not be aware of potential increase in ability with use of prosthesesSlide16
ConclusionsImproved focus on specific needs based training.
Lifetime, follow-up training
Research to improve training techniques.Slide17
Questions? Applications? How can we apply this information to the work that we do with clients using prostheses?
What training is available now for farmers who experience amputation?
Any farm specific occupational training?
Are we looking at all aspects of life when we work with clients?
Recreation, activities of daily living, etc.