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Needs & wants in rehabilitation therapy for a myoelectric prosthesis after an arm-hand amputation

Kolkman, S. (2013) Needs & wants in rehabilitation therapy for a myoelectric prosthesis after an arm-hand amputation.

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Abstract:OBJECTIVE Limb loss is a potentially devastating event in a person’s life, often resulting in profound physical, psychological and vocational consequences. After amputation the patient can choose to wear a myoelectric prosthesis. To be able to use the prosthetic in the right way, the patient will rehabilitate and train with the prosthetic guided by the physiotherapist and occupational therapist. The goal of this research is to identify attributes which result in high effectiveness of the rehabilitation therapy for a myoelectric prosthesis according to the patients and the health care professionals. METHODS Data was collected in multiple stages. To find out what is known from the literature regarding attributes which result in high effectiveness of the rehabilitation and successful use of the myoelectric upper limb prosthesis a systematic literature search is done. To identify attributes besides the ones found in literature which can influence successful rehabilitation interviews were done with health care professionals. To structure the attributes found in literature and interviews the UTAUT model was used. At the end of the interview a list of attributes which were found in literature were shown to the interviewees. On a rating scale from no influence at all to very large influence the interviewees scored the characteristics to identify the importance of the attributes which were found in literature. To identify the importance of the found attributes according to the patients an online questionnaire using the Analytic Hierarchy Process (AHP), a multi criteria decision analysis technique developed by Saaty, was used. RESULTS Patients and health care professionals agree that the expectations the patients have of the myoelectric prosthesis have the largest influence on the effectiveness of the rehabilitation therapy, and that the facilitating conditions are least important. The patients and health care professionals have different opinions about some of the other attributes. Where the health care professionals ranked the factors concerning the effort expectancy of the training as having a low influence on the success of the rehabilitation, the patients ranked this category as important. There is agreement between the patients and health care professionals that the patients’ expectations and insight in the training are more important than the time and difficulty of the training. A remarkable difference between the answers of the patients and health care professionals is concerning the importance of the patient’s influence on the decision for the prosthesis type. The health care professionals scored this relative low, where the patients ranked this as quite important for a successful rehabilitation. The health care professionals scored that follow-up after the rehabilitation program has a large influence on successful rehabilitation where the patients gave this factor a very low relative importance. Concerning Social influences on the effectiveness of the rehabilitation there is a large disagreement between the patients and health care professionals. Where the health care professionals feel that the influence of the social environment is quite important on the successful rehabilitation, the patient ranked this category as the least important. 1 The interviews with health care professionals resulted in some new attributes which weren’t found in literature, which were part of the patient questionnaire. Three of those factors are ranked as having al large influence on the success of the rehabilitation by the patients: • Offering the patients the opportunity to try different prosthetic options before choosing a prosthesis type • Regular measurements of the patients’ progress during the rehabilitation • Focusing the rehabilitation on a patient’s occupation RECOMMENDATIONS Health care professionals need to make sure the patient has the right expectations before the decision for a prosthesis type is made. • Give the patients accurate and realistic information in an early stage to prevent the patients from constructing wrong expectations. • Offering the patient the option of trying different options before making a decision can make sure the patient has the correct expectations of the different prosthetic options. • More research about how patients form their expectancies can help give the health care professionals insight in the process a patient goes through when choosing a prosthetic option. Besides factors concerning the expectancy the patients has of the myoelectric prosthesis, some other factors were found that could be improved the successful rehabilitation. • Regular measurement of the patients’ progress and communication of this progress with the patient can help keep the patient motivated. • A person’s occupation is a large part of a persons’ daily life. Focusing the rehabilitation on the patients occupation makes sure the patient will use the prosthesis in his or her daily life in the right way, also when working.
Item Type:Essay (Master)
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:88 social and public administration
Programme:Health Sciences MSc (66851)
Link to this item:http://purl.utwente.nl/essays/63427
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