Body Structures and Physical Complaints in Upper Limb Reduction Deficiency: A 24-Year Follow-Up Study

Sietke G Postema,Kristina Waldenlöv,Corry K Van Der Sluis,Liselotte M Norling Hermansson,Efrat Monsonego-Ornan

doi:10.1371/journal.pone.0049727

Abstract

ObjectiveTo describe upper body structures associated with upper limb reduction deficiency and the development of these structures over time, to examine the presence of physical complaints in this population, and to compare body structures and complaints between groups based on prosthesis use.DesignProspective cohort study with a follow-up period of 24 years, with matched able-bodied controls.SubjectsTwenty-eight patients with unilateral below-elbow reduction deficiency fitted with myoelectric prostheses, aged 8–18 years at inclusion.MethodMeasurements of upper arm, trunk and spine were performed and study-specific questionnaires were answered at baseline and follow-up; the Brief Pain Inventory and the Quick Disability of Arm, Shoulder, and Hand questionnaires were answered at follow-up.ResultsBoth at baseline and follow-up, within-subjects differences in structures of the arm and trunk were shown in patients but not in controls. Spinal deviations, although small, were greater in patients compared to controls. Self-reported disability was higher in patients compared to controls. Differences in back pain and effect of prostheses use could not be shown.ConclusionsPatients with unilateral below-elbow reduction deficiency have consistent differences in upper body structures. Deviations of the spine, probably of functional origin, do not progress to clinically relevant scoliosis.

Highlights

Very little is known about the development of the upper body structures of children with upper limb reduction deficiency (ULRD)
Small, were greater in patients compared to controls
This study aims to i) describe the body structures of the spine, trunk and arms in patients with unilateral ULRD compared to able-bodied controls, ii) describe the development of the structures of arms and trunk over time, iii) examine the presence of physical complaints in patients with ULRD compared to able-bodied controls, and iv) compare body structures and physical complaints between groups based on prosthesis use

Summary

Introduction

Very little is known about the development of the upper body structures of children with upper limb reduction deficiency (ULRD). Little is known about back pain or other physical complaints that these patients may experience in adulthood. Earlier studies on physical complaints in individuals with a short arm have reported rates of arm and back complaints of 40–55% among the examined population [3,4,5,6]. These studies did not focus on patients with ULRD, who differ from those with amputations in that they are more able to use both the affected and unaffected arm to perform daily tasks due to natural adaptation. More insight into physical complaints in older patients is valuable

Methods

Results

Conclusion