Actual prosthetic usage in relation to functional outcomes and wearing time in individuals with below-elbow amputation.

ABSTRACT

BACKGROUND: Wearing time of a prosthesis is regarded as an indicator for success of prosthetic rehabilitation. However, prostheses are frequently worn for esthetic purposes only. Although different supervised measurements to assess prosthetic dexterity are used, it is not clear how performance in such tests translates into actual use in everyday life. OBJECTIVES: To evaluate the actual daily use of the prosthetic device in patients with below-elbow amputations by recording the number of grasping motions. STUDY DESIGN: Observational study. METHODS: Upper extremity function was evaluated using different objective and timed assessments in five unilateral patients with below-elbow amputations. In addition, patients reported daily wearing time, and the number of performed prosthetic movements over a period of at least three months was recorded. RESULTS: The patients achieved a mean Southampton Hand Assessment Procedure score of 66.60 ± 18.64 points. The average blocks moved in the Box and Block Test were 20.80 ± 7.46, and the mean score in the Action Research Arm Test was 37.20 ± 5.45. The mean time for the Clothespin-Relocation Test was 26.90 ± 11.61 seconds. The patients reported a wearing time of an average of 12.80 ± 3.11 hours per day. The mean number of prosthetic motions performed each day was 257.23 ± 192.95 with a range from 23.07 to 489.13. CONCLUSIONS: Neither high functionality nor long wearing times necessitated frequent use of a prosthesis in daily life. However, frequent daily motions did translate into good functional scores, indicating that regular device use in different real-life settings relates to functionality.