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Presented by: Richard J. Straub, PhD Project Leader

Pilot Survey Results Regarding Upper Extremity Prosthesis Use and Issues Among Wisconsin AgrAbility Clients. Presented by: Richard J. Straub, PhD Project Leader University of Wisconsin-Madison, Biological Systems Engineering Department. AgrAbility of Wisconsin. Contributors.

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Presented by: Richard J. Straub, PhD Project Leader

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  1. Pilot Survey Results Regarding Upper Extremity Prosthesis Use and Issues Among Wisconsin AgrAbility Clients. Presented by: Richard J. Straub, PhD Project Leader University of Wisconsin-Madison, Biological Systems Engineering Department. AgrAbility of Wisconsin.

  2. Contributors University of Wisconsin – Madison Occupational Therapy Program, Department of Kinesiology • Joshua J. Hedrich, MSOT • Dorothy F. Edwards, PhD Medstar Health Systems – National Rehabilitation Hospital, Washington, D.C. • Rahsaan J. Holley, MS, OTR • Alexander W. Dromerick, MD University of Wisconsin-Madison, Biological Systems Engineering Department/AgrAbility of Wisconsin • Robert H. Meyer, MS • Richard J. Straub, PhD

  3. Background • AgrAbility of Wisconsin was approached in the Fall of 2009 to assist with a survey related to upper extremity amputation and prosthetic training. • The investigators were interested in any differences between rural and urban populations.

  4. Project purpose and participants • To explore the effects of: • upper extremity prosthesis use, and • prosthetic training on the functional ability of individuals with an upper extremity amputation • 74 clients (past and current) of the AgrAbility of Wisconsin program.

  5. Survey Basics • Self-report mail based survey: • Characteristics of participants • Location and etiology of amputation, prosthesis type, use and frequency • Self-efficacy in prosthesis use and common activities. • Training involved in learning to use prosthesis • DASH (Disabilities of the Arm, Shoulder and Hand) • Standardized, valid survey instrument (30 items) • Demographic and employment questions

  6. Methods • Survey packets were provided to AgrAbility of Wisconsin. • Survey, introduction letter and reply postage paid envelope (returned directly to UW Survey Center) • AgrAbility of Wisconsin inserted a personalized letter describing the purpose and informing the clients of their rights under our UW-Extension IRB guidelines. • No follow up procedures or incentives were used. Participants were informed in the AAW letter that this was a one-time survey mailing.

  7. Results • Total number of surveys mailed out: 74 • Completed surveys returned: 20 (1 was returned incomplete) • Response rate 27%

  8. Demographics • 19 male, 1 female • Mean age 54 (S.D. 11.7) Range 34 – 82 • Amputation level • Partial hand - 7 • Wrist disarticulation - 3 • Below elbow - 4 • At elbow - 1 • Below shoulder - 3 • At shoulder - 3

  9. Etiology of Amputations • 19 civilian related trauma (9 specifically listed farm accident as cause) • 1 birth related defect Timeframe: • 2000 - 2009 - 5 amputations • 1990 - 1999 - 7 amputations

  10. Prosthetic Use • 12 individuals indicated current or prior use of a device: • Cosmetic - 4 • Body powered - 9 • Externally powered - 2 • Hybrid - 1 • Number of days used in last month: • 0 days - 2 • 1 - 10 days - 2 • At least 28 days - 7 • Did not indicate - 1 • Length of time per day used in previous week: • 0 - 3 hours - 1 individual • 7 to 9 hours - 3 individuals • 10 + hours - 4 individuals • Did not indicate - 4 individuals *note some clients reported use of more than 1 type of device.

  11. Ability to use prosthesis in certain activities:

  12. Ability to perform tasks, continued…

  13. Client Responses • Holding objects during activity, including holding nails to hammer, holding string to tie knot or shoes, holding book or papers • Meal preparation activities, includes using a knife, peeling vegetables • Carrying objects • Operating vehicle/farm equipment/power tools • Using manual labor tools, including shovels, forks, scrapers

  14. Discussion • Participants reported some degree of success with prostheses • Some areas from the previous table indicate a desire to perform a task • Writing, overhead tasks, recreation • Small sample size limits conclusions, this is informational, pilot data only.

  15. Discussion, Cont. • Why did those individuals who said they received training score higher on the disability level? • Possibly the extent of the amputation -- those with the greatest amputation were offered more training. • Participants may not be aware of potential increase in ability with use of prostheses

  16. Conclusions • Improved focus on specific needs based training. • Lifetime, follow-up training • Research to improve training techniques.

  17. Questions? Applications? • How can we apply this information to the work that we do with clients using prostheses? • What training is available now for farmers who experience amputation? • Any farm specific occupational training? • Are we looking at all aspects of life when we work with clients? • Recreation, activities of daily living, etc.

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