Short-term effects of an active prosthetic solution on functional ability, level of activity and participation of children with unilateral transtibial amputations

Date
2020-12
Journal Title
Journal ISSN
Volume Title
Publisher
Stellenbosch : Stellenbosch University
Abstract
ENGLISH ABSTRACT: Introduction. Children require ≥60 minutes of physical activity a day. Children with disabilities often find it challenging to reach this activity goal due to various factors, including task at hand, environment, and type of disability. The activity levels of children with a unilateral transtibial amputation (UTTA) are often dependent on their access to suitable prosthetic solutions. Although various prosthetic solutions are available, cost is a very real consideration. The more accurately the prosthesis mimics the working and appearance of a sound leg, the more expensive it generally is. Children from a low Socioeconomic Status (SES) background which measures economic and social position, do not have access to the latest prosthetic technology, consequently, they are less likely to meet their daily activity goals and/or attain optimal functional mobility. Therefore, the aim of the study was to determine whether children, living in families with a low social economic status, could adapt to a new active prosthesis within a 4-week adaptation period. Methods. Eight participants (5 girls and 3 boys), ranging in ages from 6 to 16, were recruited from the Western Cape Centre for Prosthetics and Orthotics, with a low SES. Functional mobility was assessed via 5 functional tests. Daily activity and participation were determined using a Polar Loop activity tracker for one week after each test date and the PEDI-CAT questionnaire. Participants were first tested in their old prosthesis, a Solid Ankle Cushioned Heel (SACH) prosthesis, before being fitted and tested with a new Össur active prosthesis which better suited their activity demands. Results. Short-term results were obtained after 4 weeks of wearing the new prosthesis. In terms of functional mobility and level of activity, results seemed like outcomes attained when wearing the old prosthesis. Discussion. Findings of this study show that children with a UTTA can adapt quickly to a new prosthesis. In the functional movement tests, activity tracker and PEDI-CAT, no significance was found between the two feet, assessed balance variables returned to pre-fitment values after 4 weeks. In line with another study, the iTUG tests revealed no benefits. In line with other studies, gait parameters and iTUDS remained the same. Neither PEDI-CAT nor the activity tracking revealed significant values. However, this could be testament that the participants in this study were limited to the 4 weeks of data analyses and after only 4 weeks already had a similar outcome to their old feet.
AFRIKAANSE OPSOMMING: Inleiding. Kinders benodig ≥60 minute fisieke aktiwiteite per dag. As gevolg van verskeie faktore, wat die taak, omgewing en tipe gestremdheid insluit, vind kinders met gestremdhede dit uitdagend om hierdie doelwit te bereik. Kinders met unilaterale transtibiale amputasies (UTTA) is dikwels afhanklik van die geskikte prostese oplossing. Alhoewel ‘n verskeidenheid prostese oplossings beskikbaar is, speel die bekosbaarheid daarvan ‘n belangrike rol. Kinders met ‘n agtergrond van ‘n laer sosio-ekonomiese status (SES), ‘n meting van die sosiale en ekonomiese stand van die huishouding, het nie toegang tot die nuutste tegnologie nie. Gevolglik is die kanse laer dat hul, hul daaglikse aktiwiteitsvlakke en of optimale funksionele mobiliteit sal behaal. Metodes. Agt deelnemers (vyf meisies en drie seuns), met ‘n ouderdom reikwydte van 6-18 jaar, was deur die Weskaapse Sentrum vir Prostese en Ortose genader vir die studie. Funksionele mobiliteit was deur middel van twee funksionele toetse bepaal. Daaglikse aktiwiteits deelname was deur middel van die Polar Loop aktiwiteitsmonitor en die PEDI-CAT vraelys bepaal. Deelnemers was eers met hul ou prostese oplossing geassesseer en weer na die passing van die nuwe Össur aktiewevoet prostese oplossing. Die nuwe Össur aktiewe voet prostese oplossing was meer geskik vir hul aktiwiteitsvlak. Resultate. Na vier weke op die nuwe aktiewe prostese oplossing toon die resultate dat die meeste uiktomste behoue gebly het tussen die ou en nuwe prostese oplossing. Bespreking. Bevindinge van die studie toon aan dat kinders vining aanpas by ‘n nuwe prostese oplossing. Dit wil voorkom of die resultate van die funksionele bewegingstoetse, die aktiwiteitsmoniteerder en die PEDI-CAT, van die ou prostese behoue gebly het. Geen betekenisvolle resultate tussen die twee prostese oplossings was gevind nie. Die veranderlikes van die balans aktiwiteite wat gemeet was, het terug gekeer na waardes van die ou prostese oplossing. Dit stem ooreen met resultate van nog ‘n studie waar die iTUG toets geen voordele uitgewys het nie. Die looppatroon en iTUDS resultate het onveranderlik gebly, wat ook resultate van ‘n vorige studie ondersteun. Geen van die PEDI-CAT of monitoring van die aktiwiteitsvlakke het betekenisvolle resultate aangetoon nie. Die lae SES vlakke van meeste van die deelnemers se huishoudings kon moontlik ‘n impak gehad het.
Description
Thesis (MSc)--Stellenbosch University, 2020.
Keywords
Prosthesis -- Children, Physical fitness -- Children, Children with disabilities -- Orientation and mobility, Leg -- Amputation -- Children, Western Cape Centre for Prosthetics and Orthotics, Poor -- Medical care -- Children, Poor -- Medical technology -- Children, UCTD
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