Use of the DEKA Arm for amputees with brachial plexus injury: A case series.
Use of the DEKA Arm for amputees with brachial plexus injury: A case series.
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DOI：
10.1371/journal.pone.0178642
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发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
Sepulveda E
中科院分区：
文献类型：
--
作者：
Resnik L;Fantini C;Latlief G;Phillips S;Sasson N;Sepulveda E
上肢截肢及臂丛神经损伤患者假体排斥发生率高。研究目的是描述经肱骨截肢和臂丛损伤的受试者的经历，这些受试者适合并训练使用DEKA手臂。这是一项混合方法研究，利用定性（如访谈、调查）和定量数据（如自我报告和绩效测量）。受试者1，目前使用假体，有肩关节融合术。受试者2，非假体使用者，肩部半脱位。两人都在实验室接受了培训，并参加了家庭使用试验。对过程和结果进行描述性分析。受试者1安装了经肱骨配置（HC） DEKA手臂，使用压缩释放稳定套筒。他接受了12小时的假肢训练，并参加了所有的家庭学习活动。受试者1对DEKA机械臂的灵巧性和义肢满意度有所提高，并在参与结束时报告了更好的生活质量（QOL）。受试者2使用改良的x -框架插座安装肩位（SC） DEKA手臂。他接受了30小时的培训，并参加了为期3周的家庭活动。与基线相比，他在训练结束时报告的功能残疾较少，但遇到个人问题和PTSD症状加重，并在3周时退出家庭使用部分。两名受试者都报告了使用后的功能益处，并表达了将来接受DEKA手臂的愿望。本文报道了两种不同的假肢拟合策略及其结果。讨论了每种方法的优点和局限性。在TH截肢和臂丛损伤患者中同时使用HC和SC DEKA臂有报道。从中获得的经验教训可能对临床医生考虑未来病例的假肢选择具有指导意义。
Patients with upper limb amputation and brachial plexus injuries have high rates of prosthesis rejection. Study purpose is to describe experiences of subjects with transhumeral amputation and brachial plexus injury, who were fit with, and trained to use, a DEKA Arm. This was a mixed-methods study utilizing qualitative (e.g. interview, survey) and quantitative data (e.g. self-report and performance measures). Subject 1, a current prosthesis user, had a shoulder arthrodesis. Subject 2, not a prosthesis user, had a subluxed shoulder. Both were trained in laboratory and participated in a trial of home use. Descriptive analyses of processes and outcomes were conducted. Subject 1 was fitted with the transhumeral configuration (HC) DEKA Arm using a compression release stabilized socket. He had 12 hours of prosthetic training and participated in all home study activities. Subject 1 had improved dexterity and prosthetic satisfaction with the DEKA Arm and reported better quality of life (QOL) at the end of participation. Subject 2 was fit with the shoulder configuration (SC) DEKA Arm using a modified X-frame socket. He had 30 hours of training and participated in 3 weeks of home activities. He reported less functional disability at the end of training as compared to baseline, but encountered personal problems and exacerbation of PTSD symptoms and withdrew from home use portion at 3 weeks. Both subjects reported functional benefits from use, and expressed a desire to receive a DEKA Arm in the future. This paper reported on two different strategies for prosthetic fitting and their outcomes. The advantages and limitations of each approach were discussed. Use of both the HC and SC DEKA Arm for patients with TH amputation and brachial plexus injury was reported. Lessons learned may be instructive to clinicians considering prosthetic choices for future cases.