gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

Cross-Sectional International Multicenter Study on Quality of Life and Reasons for Abandonment of Upper Limb Prostheses

Meeting Abstract

  • presenting/speaker Michiro Yamamoto - Nagoya University, Nagoya, Japan
  • Hitoshi Hirata - Nagoya University, Nagoya, Japan
  • Jumpei Oba - Kobe Gakuin University, Kobe, Japan
  • Hirotaka Tanaka - Chubu Rosai Hospital, Nagoya, Japan
  • Takaaki Chin - Hyogo Rehabilitation Center Central Hospital, Kobe, Japan
  • Takashi Nakamura - National Rehabilitation Center, Tokorozawa, Japan
  • Kevin Chung - University of Michigan, Ann Arbor, United States

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-168

doi: 10.3205/19ifssh0858, urn:nbn:de:0183-19ifssh08583

Published: February 6, 2020

© 2020 Yamamoto et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objectives/Interrogation: The purpose of this cross-sectional multicenter study was to examine prosthesis use and abandonment among patients with upper limb deficiencies in the USA and Japan. We determined the most common reasons for abandonment and compared prosthesis users and nonusers according to a variety of demographic and clinical characteristics. We hypothesized that prosthesis users would have higher QOL than nonusers, and that patients who used myoelectric prostheses were more likely to be employed full-time. We also compared EQ-5D scores between patients and live-in proxies to determine the agreement in QOL between patients and their close relationships, hypothesizing that patient-reported QOL would be superior to proxy-reported values.

Methods: Three rehabilitation centers in Japan and one academic medical center in the USA participated. Patients aged between 12 and 75 years with unilateral or bilateral upper limb absence from the level of wrist to shoulder disarticulation were included. Two questionnaires were used, an original questionnaire on prosthesis use and the EQ-5D, which was completed by both the participant and by a live-in proxy on the participant's behalf.

Results and Conclusions: Among 367 patients invited, 174 patients with upper limb loss participated in this study. Male patients made up 65% of the study population. The most common amputation level was trans-radial. Trauma was the most common cause of limb loss. The prosthesis rejection rate was 9% (n=16). The most common reason for abandonment was prosthesis functionality. Ten of 16 prosthesis nonusers (63%) and 59 prosthesis users (38%) were unemployed, whereas only 5 prosthesis nonusers (31%) and 87 prosthesis users (56%) were working full-time or part-time. There were no significant demographic differences between prosthesis users and nonusers including age, gender, dominant or nondominant hand involvement, cohabitation status, or health status. The mean EQ-5D utility score of prosthesis users was significantly higher than that of nonusers (p<0.01). Live-in proxies significantly overestimated and underestimated the QOL in male and female patients, respectively.

It is beneficial for society to provide intensive rehabilitation to upper limb prosthesis users and minimize prosthesis rejection because prosthesis users have greater productivity than nonusers. Furthermore, particular attention should be given to avoiding the overestimation of QOL in male patients with upper limb deficiency.