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- Hermansson, Liselotte M. N.
(författare)
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Upper limb reduction deficiencies in Swedish children : classification, prevalence and function with myoelectric prostheses
- 2004
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Upper limb reduction deficiency (ULRD) is a rare condition that has been known ever since the 6th century B.C. This is a lifelong deficiency which in an afflicted child can lead to practical limitations, social restrictions and physical problems. The overall aim of this research was to increase the knowledge about children with upper limb reduction deficiencies from three perspectives: the deficiencies themselves, the use of prostheses and the well being of the affected children. To validate information regarding ULRD in the Swedish Register for Congenital Malformations (SRCM), all infants reported to this register during 1973-1987 were re-classified according to a more detailed classification. The result was compared with a clinic-based register at the Limb Deficiency and Arm Prostheses Centre in Örebro, Sweden. The findings indicate that SRCM, with its calculated underestimation of 6%, can be used for studying the prevalence of ULRD in Sweden. However, as SRCM is a surveillance register, the quality of some information seems to be low, making detailed description of cases difficult. Use of the population register data for clinical purposes could therefore result in lower validity. Additional information and follow-up of specific cases are therefore recommended.The presence of scoliosis and trunk asymmetry was studied in 60 persons with transverse ULRD. Nineteen persons (31%) had a scoliosis of between 10 and 19º and 30 persons had minor curves of between 5 and 10º. There was a significant correlation between leg length inequality and side of the convexity, with the convexity directed towards the side of the shorter leg in 21 of 28 persons. This indicates that children with transverse ULRD may have a transient scoliosis of postural origin of no clinical significance.A new observation-based test, the Assessment of Capacity for Myoelectric Control (ACMC), which measures a person’s capacity to control a myoelectric prosthetic hand during the performance of ordinary daily tasks, was developed. Occupational therapists completed 210 assessments of 75 persons. Rasch rating scale analysis was used for validation and reliability estimations. The results demonstrate internal scale and person response validity.The external reliability of ACMC was established by scorings from three raters with different degrees of experience on 27 videotapes of client performance. The major finding in this study was that in order to obtain reliable measures from the ACMC the raters have to have some experience of this group of clients. Until the ACMC can adjust for rater severity, the same rater should perform the ACMC when it is used for follow-up or clinical trials.In a study of 62 children we found that, overall, children with ULRD who have been fitted with a myoelectric prosthetic hand are just as well adjusted psychosocially as their able-bodied peers. There are indications, however, of social stigmata related to the deficiency which have to be considered differently in boys and girls. Most children who have been provided with a myoelectric prosthesis at an early age continue to use the prosthesis.
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- Lindner, Helen Y N, 1967-, et al.
(författare)
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Influence of tasks on the validity for the Assessment of Capacity for Myoelectric Control (Acmc)
- 2013
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Ingår i: ISPO 2013 World Congress. - : International Society for Prosthetics and Orthotics.
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Konferensbidrag (refereegranskat)abstract
- Introduction: The Assessment of Capacity for Myoelectric Control (ACMC) is an observational based instrument that evaluates the ability to operate a myoelectric prosthetic hand. It is performed during the execution of bimanual tasks chosen by the clients. Although the ACMC does not assess task performance, it is unknown whether the clients’ ability measures are influenced by factors such as task complexity. The study aim was therefore to develop standardized tasks and to examine whether (i) the clients’ ability measures are influenced by the tasks (ii) the tasks function the same across different client characteristics based on age, sex, prosthetic side and experience.Method: Six tasks were chosen from ACMC raters’ suggestions and standardized for the ACMC. Myoelectric prosthesis users (n=58, mean age=20, 31 males) were recruited from the Örebro University Hospital, Sweden. Each user performed 3 tasks. All task performances were videotaped and rated on the 22 ACMC items according to a 4-point capability scale.Many-facets Rasch analysis was used to (i) examine whether the three ability measures of each user were significantly different from each other, and (ii) to reveal if a particular client characteristics was scored differently in a particular task.Result: No significant difference in the ability measures was found in the majority of the sample – only three sporadic users were significantly different in one or two of their tasks. This implies that the client’s ability measures are not influenced by the tasks. No significant difference was found related to prosthetic side and experience. Minor difference was found in sexes and two age groups (age 7 to 15, over 15) but the differences were too small to be clinically relevant.Conclusions: This study provides further validity evidence of the ACMC. Research with more challenging tasks is needed to confirm the findings.
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- Sköld, Annika, et al.
(författare)
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Development and evidence of validity for the children’s hand-use experience questionnaire (CHEQ)
- 2011
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Ingår i: Developmental Medicine & Child Neurology. - : Wiley-Blackwell. - 0012-1622 .- 1469-8749. ; 53:5, s. 436-442
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To describe the development of the Children's Hand-use Experience Questionnaire (CHEQ), and investigate the evidence of its validity based on test content and internal structure of the three scales in it.METHOD: The selection of items and questions was based on a literature review, expert opinion, and interviews with families. Data on the final questionnaire were collected from 86 children and adolescents (42 males, 44 females) aged 6 to 18 years (mean 12 y, SD 3 y), with unilateral cerebral palsy, upper limb reduction deficiency, or obstetric brachial plexus palsy.RESULTS: After item reduction and evaluation, CHEQ was designed to include 29 bimanual activities, each rated on three scales of perceived efficacy of the grasp, time taken to perform the activity, and degree of feeling bothered. The appropriateness of the included activities was confirmed by their reported relevance and bimanual nature. The internal structure of the scales was confirmed by Rasch analysis.INTERPRETATION CHEQ can be used to assess children and adolescents with a unilateral hand dysfunction on their experiences of using the affected hand to perform bimanual tasks. In clinical work, CHEQ has the potential to become a useful tool for treatment planning and follow-up.
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