A Small-Scale Survey of Bilateral Upper-Limb Loss Individuals

Abstract

ABSTRACT Introduction Bilateral upper-limb loss (Bil UL Loss) is perhaps the greatest challenge for upper-limb prosthetic care, now even more than ever as we witness the increase of sepsis as a cause of limb loss. Methods This small-n survey has recruited 28 individuals with Bil UL Loss, 27 of whom are prosthesis wearers. Twelve of the 28 lost four limbs to sepsis; 17 of the 27 prosthesis wearers use body-powered hooks, six use electric hooks, and four use electric hands as their dominant terminal device (within this report, dominant side is the wearer's postloss dominant side, i.e., the side the subject used more frequently). The survey used person-to-person interviews to compile the broad data about how tasks are performed, how many tasks are performed, whether two prostheses are used, and other details. Results Users of each type of prosthesis demonstrate a high level of function. Electric hook users scored slightly higher in number of tasks and other measures. However, no outcomes were significant statistically, except the use of the dominant side prosthesis, which was three times higher than the nondominant side usage. Users identified a dozen categories for desired improvements, with greater dependability and greater grip security as the most commonly requested. Discussion The information will be useful for not only for clinical guidance, but hopefully also to help guide the development of future prosthetic devices, considering that the disabled community has called for prioritizing the actual needs and desires of the consumers to guide future developments. Conclusions The planning and execution of this small-scale study could be a model for other groups to collect useful outcomes data without requiring a research grant, without large institutional oversight, and by only a small group of interested professionals with access to a reasonable number of individuals with a severe disability. Clinical Relevance All caregivers of individuals with bilateral limb loss could benefit from both the data presented and the challenges revealed by this survey group. Future prosthetic designs as well as training and other therapies will also hopefully benefit from the needs expressed directly by these consumers.