Cargando…

A national study of Veterans with major upper limb amputation: Survey methods, participants, and summary findings

INTRODUCTION: A comprehensive study to assess quality and outcomes of care for Veterans with upper limb amputation is needed. This paper presents methods and summary findings from a national survey of Veterans with upper limb amputation. METHODS: After completion of a pilot study to develop and refi...

Descripción completa

Detalles Bibliográficos
Autores principales: Resnik, Linda, Ekerholm, Sarah, Borgia, Matthew, Clark, Melissa A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6417699/
https://www.ncbi.nlm.nih.gov/pubmed/30870496
http://dx.doi.org/10.1371/journal.pone.0213578
_version_ 1783403607933059072
author Resnik, Linda
Ekerholm, Sarah
Borgia, Matthew
Clark, Melissa A.
author_facet Resnik, Linda
Ekerholm, Sarah
Borgia, Matthew
Clark, Melissa A.
author_sort Resnik, Linda
collection PubMed
description INTRODUCTION: A comprehensive study to assess quality and outcomes of care for Veterans with upper limb amputation is needed. This paper presents methods and summary findings from a national survey of Veterans with upper limb amputation. METHODS: After completion of a pilot study to develop and refine methods, computer-assisted telephone interviews were conducted with 808 Veterans with upper limb amputation (response rate = 47.7%; cooperation rate = 63.3%). RESULTS: Respondents were 776 unilateral and 32 bilateral amputees, 97.5% male, mean age 63.3 (sd 14.1). Prostheses were used by 60% unilateral and 91% bilateral, the majority used body powered devices. Prostheses were used ≥8 hours/day by 52% unilateral and 76% bilateral. Prosthetic training was received by 71% unilateral and 59% bilateral. Mean prosthetic satisfaction was 3.9 (sd 0.6) and 3.8 (sd 0.7) as measured by TAPES; and 25.0 (sd 5.1) and 25.7 (sd 4.5) as measured by OPUS CSD for unilateral and bilateral respectively. Mean perceived disability (measured by QuickDASH) scores were 49.5 (sd 20.7) for unilateral and 34.7 (sd 22.0) for bilateral. VR-12 PCS scores were below population norms. The majority reported contralateral limb pain, musculoskeletal conditions, back and neck pain. Phantom limb pain was reported in 83.4% of unilateral and 68.8% of bilateral, and residual limb pain in 65.1% of unilateral and 68.8% of bilateral. Most, (81.8% unilateral, 84.4% bilateral) had been to a Veterans Affairs medical center (VA) for amputation care, while 57% of unilateral and 81.3% of bilateral had been to a VA amputation clinic. DISCUSSION/CONCLUSION: Veterans with upper limb amputation have moderately impaired physical functioning. Prosthesis use rates were lower than previously reported. Although satisfied with their prostheses, nearly half used them ≤8 hours/day. Rates of musculoskeletal problems, phantom and residual limb pain were higher than previously reported. A substantial proportion never received prosthetic training, or VA amputation care.
format Online
Article
Text
id pubmed-6417699
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher Public Library of Science
record_format MEDLINE/PubMed
spelling pubmed-64176992019-04-01 A national study of Veterans with major upper limb amputation: Survey methods, participants, and summary findings Resnik, Linda Ekerholm, Sarah Borgia, Matthew Clark, Melissa A. PLoS One Research Article INTRODUCTION: A comprehensive study to assess quality and outcomes of care for Veterans with upper limb amputation is needed. This paper presents methods and summary findings from a national survey of Veterans with upper limb amputation. METHODS: After completion of a pilot study to develop and refine methods, computer-assisted telephone interviews were conducted with 808 Veterans with upper limb amputation (response rate = 47.7%; cooperation rate = 63.3%). RESULTS: Respondents were 776 unilateral and 32 bilateral amputees, 97.5% male, mean age 63.3 (sd 14.1). Prostheses were used by 60% unilateral and 91% bilateral, the majority used body powered devices. Prostheses were used ≥8 hours/day by 52% unilateral and 76% bilateral. Prosthetic training was received by 71% unilateral and 59% bilateral. Mean prosthetic satisfaction was 3.9 (sd 0.6) and 3.8 (sd 0.7) as measured by TAPES; and 25.0 (sd 5.1) and 25.7 (sd 4.5) as measured by OPUS CSD for unilateral and bilateral respectively. Mean perceived disability (measured by QuickDASH) scores were 49.5 (sd 20.7) for unilateral and 34.7 (sd 22.0) for bilateral. VR-12 PCS scores were below population norms. The majority reported contralateral limb pain, musculoskeletal conditions, back and neck pain. Phantom limb pain was reported in 83.4% of unilateral and 68.8% of bilateral, and residual limb pain in 65.1% of unilateral and 68.8% of bilateral. Most, (81.8% unilateral, 84.4% bilateral) had been to a Veterans Affairs medical center (VA) for amputation care, while 57% of unilateral and 81.3% of bilateral had been to a VA amputation clinic. DISCUSSION/CONCLUSION: Veterans with upper limb amputation have moderately impaired physical functioning. Prosthesis use rates were lower than previously reported. Although satisfied with their prostheses, nearly half used them ≤8 hours/day. Rates of musculoskeletal problems, phantom and residual limb pain were higher than previously reported. A substantial proportion never received prosthetic training, or VA amputation care. Public Library of Science 2019-03-14 /pmc/articles/PMC6417699/ /pubmed/30870496 http://dx.doi.org/10.1371/journal.pone.0213578 Text en https://creativecommons.org/publicdomain/zero/1.0/ This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 (https://creativecommons.org/publicdomain/zero/1.0/) public domain dedication.
spellingShingle Research Article
Resnik, Linda
Ekerholm, Sarah
Borgia, Matthew
Clark, Melissa A.
A national study of Veterans with major upper limb amputation: Survey methods, participants, and summary findings
title A national study of Veterans with major upper limb amputation: Survey methods, participants, and summary findings
title_full A national study of Veterans with major upper limb amputation: Survey methods, participants, and summary findings
title_fullStr A national study of Veterans with major upper limb amputation: Survey methods, participants, and summary findings
title_full_unstemmed A national study of Veterans with major upper limb amputation: Survey methods, participants, and summary findings
title_short A national study of Veterans with major upper limb amputation: Survey methods, participants, and summary findings
title_sort national study of veterans with major upper limb amputation: survey methods, participants, and summary findings
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6417699/
https://www.ncbi.nlm.nih.gov/pubmed/30870496
http://dx.doi.org/10.1371/journal.pone.0213578
work_keys_str_mv AT resniklinda anationalstudyofveteranswithmajorupperlimbamputationsurveymethodsparticipantsandsummaryfindings
AT ekerholmsarah anationalstudyofveteranswithmajorupperlimbamputationsurveymethodsparticipantsandsummaryfindings
AT borgiamatthew anationalstudyofveteranswithmajorupperlimbamputationsurveymethodsparticipantsandsummaryfindings
AT clarkmelissaa anationalstudyofveteranswithmajorupperlimbamputationsurveymethodsparticipantsandsummaryfindings
AT resniklinda nationalstudyofveteranswithmajorupperlimbamputationsurveymethodsparticipantsandsummaryfindings
AT ekerholmsarah nationalstudyofveteranswithmajorupperlimbamputationsurveymethodsparticipantsandsummaryfindings
AT borgiamatthew nationalstudyofveteranswithmajorupperlimbamputationsurveymethodsparticipantsandsummaryfindings
AT clarkmelissaa nationalstudyofveteranswithmajorupperlimbamputationsurveymethodsparticipantsandsummaryfindings