Journal of Rehabilitation Research & Development (JRRD)

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Volume 47 Number 4, 2010
   Pages 299 — 316

Abstract —  Unilateral upper-limb loss: Satisfaction and prosthetic-device use in veterans and servicemembers from Vietnam and OIF/OEF conflicts

Lynne V. McFarland, PhD;1* Sandra L. Hubbard Winkler, PhD, OTR/L, ATP;2 Allen W. Heinemann, PhD;3 Melissa Jones, PhD, OTR/L, CHT, LTC;4 Alberto Esquenazi, MD5

1Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA; and University of Washington, Seattle, WA; 2Rehabilitation Outcomes Research Center Research Enhancement Award Program, North Florida/South Georgia Veterans Health System, Gainesville, FL; and University of Florida, Gainesville, FL; 3Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL; and Center for Rehabilitation Outcomes Research, Rehabilitation Institute of Chicago, Chicago, IL; 4U.S. Army, Manhattan, KS; 5Department of Physical Medicine and Rehabilitation, MossRehab and Albert Einstein Medical Center, Elkins Park, PA

Abstract — Prosthetic use and satisfaction in wounded servicemembers and veterans with unilateral upper-limb loss has not been thoroughly explored. Through a national survey, we enrolled 47 participants from the Vietnam conflict and 50 from Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) with combat-associated major unilateral upper-limb loss. Upper-limb prosthetic devices were used by 70% of the Vietnam group and 76% of the OIF/OEF group. Mechanical/body-powered upper-limb devices were favored by the Vietnam group, while a combination of myoelectric/hybrid and mechanical/body-powered devices were favored by the OIF/OEF group. Upper-limb devices were completely abandoned in 30% of the Vietnam and 22% of the OIF/OEF groups. Abandonment was more frequent for transhumeral and more proximal levels (42% of Vietnam and 40% of OIF/OEF) than more distal limb-loss levels. Upper-limb prostheses were rejected because of dissatisfaction with the device by significantly fewer (23%) members of the Vietnam group than the OIF/OEF group (45%) (p < 0.001). Most common reasons for rejection included pain, poor comfort, and lack of functionality. A significant paradigm shift has been noted in the OIF/OEF group, who use a greater number and diversity of upper-limb prostheses than the Vietnam group.

Key words: abandonment, activity measure, limb loss, OIF/OEF, prosthetic device, rehabilitation, satisfaction, upper-limb loss, veterans, Vietnam conflict.

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Last Reviewed or Updated  Monday, June 14, 2010 12:42 PM

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