Article

PURPOSE: To identify and gain agreement on successful outcomes of and important
factors to consider in rehabilitation following upper limb absence (ULA). METHOD:
Fifty-three participants consisting of multi-disciplinary rehabilitation
professionals, and individuals with ULA were invited to complete a three-round
modified Delphi iterative survey. Following three Delphi questionnaire rounds,
participants clarified the definitions of success in three areas (prosthesis use,
activities and participation and self-image). In addition, participants
identified and agreed the important factors to consider in rehabilitation after
ULA. RESULTS: Results showed that participants reached agreement (having a SD <1)
over the three rounds on 78 out of 81 rated items. Of these, 54 rated items were
"accepted" as important by panel members (mean score of 4 on a five-point Likert
scale). Twenty-four items were rejected. Only three rated items had not reached
agreement by the third round. CONCLUSIONS: Clarification of successful outcomes
and factors that should be taken into consideration in a patient's rehabilitation
allows a clearer evaluation of what should be the focus of rehabilitation. The
findings from the Delphi study can help form the basis for a screening tool for
clinicians to be able to identify areas of concern and subsequent treatment for a
patient in their care. Implications for Rehabilitation To date, there has been no
definitive guidance on which outcomes should be assessed in amputation
rehabilitation. This study identified the seven core domains of importance
regarding the rehabilitation of individuals with ULA and created a starting point
for developing a new portfolio of research that aims to address all relevant
aspects of patients' rehabilitation. This study reached a consensus and enabled
an insight into what defines successful prosthesis use, self-image and activities
and participation, and provided evidence that the current definition of
prosthesis use in the literature does not sufficiently capture what RPs and
individuals with ULA consider important, such as specific use of the prosthesis,
as often as an individual wishes, while using it as intended. This study provided
RPs and individuals with ULA an opportunity to communicate their opinions and
knowledge anonymously regarding the important areas to consider in
rehabilitation.

Langue : ANGLAIS