Article

OBJECTIVES: To compare the sensibility of the stump in adults with an acquired
major upper extremity amputation with the sensibility of the unaffected side and
with the corresponding body parts of healthy controls, as well as to relate the
sensibility of the stump to daily functioning. DESIGN: A survey with matched
controls. SETTING: A tertiary referral center. PARTICIPANTS: A referred sample of
patients (n=30) with an acquired upper extremity amputation, at least 1 year
after amputation, and control subjects (n=30) matched for age, sex, and hand
dominance were evaluated. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES:
Three different modalities of sensibility were measured: (1) touch-pressure
sensibility, tested using Semmes-Weinstein monofilaments; (2) stereognosis,
detected using the Shape and Texture Identification test; and (3) kinesthesia.
Daily functioning was assessed using the Upper Extremity Functional Status Module
of the Orthotics and Prosthetics Users' Survey. RESULTS: The mean time +/- SD
since amputation was 20+/-17.8 years. Twenty patients used a prosthesis. The
stump sensibility was similar to that of unaffected hands and tended to be less
than that of unaffected arms (P=.08). The patients using a prosthesis had
significantly poorer touch-pressure sensibility in the stump compared with the
nonusers (P=.04). However, touch-pressure sensibility and stereognosis were worse
in the patients than in controls (P<.001 and P=.03, respectively). Two patients
were able to identify shapes using their stump. Kinesthesia of the shoulders and
elbows did not differ between the affected and unaffected side. Moreover, daily
functioning was not related to sensibility. CONCLUSIONS:
The touch-pressure
sensibility in the stumps of patients using prostheses was poorer than the
sensibility in nonusers, and remarkably, the unaffected extremities of the
amputees were less sensitive than the extremities of the controls.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS