Sensibility of the Stump in Adults With an Acquired Major Upper Extremity Amputation

Abstract Objectives To compare the sensibility of the stump in adults with an acquired major upper extremity amputation with the sensibility of the unaffected side and with the corresponding body parts of healthy controls, as well as to relate the sensibility of the stump to daily functioning. Desig...

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Veröffentlicht in:Archives of physical medicine and rehabilitation 2013-11, Vol.94 (11), p.2179-2185
Hauptverfasser: van Gils, Willemijn, MD, Reinders-Messelink, Heleen A., MSc, PhD, Smit-Klaij, Frida, MD, PhD, Bongers, Raoul M., MSc, PhD, Dijkstra, Pieter U., PhD, van der Sluis, Corry K., MD, PhD
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container_issue 11
container_start_page 2179
container_title Archives of physical medicine and rehabilitation
container_volume 94
creator van Gils, Willemijn, MD
Reinders-Messelink, Heleen A., MSc, PhD
Smit-Klaij, Frida, MD, PhD
Bongers, Raoul M., MSc, PhD
Dijkstra, Pieter U., PhD
van der Sluis, Corry K., MD, PhD
description Abstract Objectives To compare the sensibility of the stump in adults with an acquired major upper extremity amputation with the sensibility of the unaffected side and with the corresponding body parts of healthy controls, as well as to relate the sensibility of the stump to daily functioning. Design A survey with matched controls. Setting A tertiary referral center. Participants A referred sample of patients (n=30) with an acquired upper extremity amputation, at least 1 year after amputation, and control subjects (n=30) matched for age, sex, and hand dominance were evaluated. Interventions Not applicable. Main Outcome Measures Three different modalities of sensibility were measured: (1) touch-pressure sensibility, tested using Semmes-Weinstein monofilaments; (2) stereognosis, detected using the Shape and Texture Identification test; and (3) kinesthesia. Daily functioning was assessed using the Upper Extremity Functional Status Module of the Orthotics and Prosthetics Users' Survey. Results The mean time ± SD since amputation was 20±17.8 years. Twenty patients used a prosthesis. The stump sensibility was similar to that of unaffected hands and tended to be less than that of unaffected arms ( P =.08). The patients using a prosthesis had significantly poorer touch-pressure sensibility in the stump compared with the nonusers ( P =.04). However, touch-pressure sensibility and stereognosis were worse in the patients than in controls ( P
doi_str_mv 10.1016/j.apmr.2013.05.025
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Design A survey with matched controls. Setting A tertiary referral center. Participants A referred sample of patients (n=30) with an acquired upper extremity amputation, at least 1 year after amputation, and control subjects (n=30) matched for age, sex, and hand dominance were evaluated. Interventions Not applicable. Main Outcome Measures Three different modalities of sensibility were measured: (1) touch-pressure sensibility, tested using Semmes-Weinstein monofilaments; (2) stereognosis, detected using the Shape and Texture Identification test; and (3) kinesthesia. Daily functioning was assessed using the Upper Extremity Functional Status Module of the Orthotics and Prosthetics Users' Survey. Results The mean time ± SD since amputation was 20±17.8 years. Twenty patients used a prosthesis. The stump sensibility was similar to that of unaffected hands and tended to be less than that of unaffected arms ( P =.08). The patients using a prosthesis had significantly poorer touch-pressure sensibility in the stump compared with the nonusers ( P =.04). However, touch-pressure sensibility and stereognosis were worse in the patients than in controls ( P &lt;.001 and P =.03, respectively). Two patients were able to identify shapes using their stump. Kinesthesia of the shoulders and elbows did not differ between the affected and unaffected side. Moreover, daily functioning was not related to sensibility. Conclusions The touch-pressure sensibility in the stumps of patients using prostheses was poorer than the sensibility in nonusers, and remarkably, the unaffected extremities of the amputees were less sensitive than the extremities of the controls.</description><identifier>ISSN: 0003-9993</identifier><identifier>EISSN: 1532-821X</identifier><identifier>DOI: 10.1016/j.apmr.2013.05.025</identifier><identifier>PMID: 23796687</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Aged ; Amputation ; Amputation Stumps ; Female ; Humans ; Kinesthesis ; Male ; Middle Aged ; Physical Medicine and Rehabilitation ; Rehabilitation ; Sensation ; Stereognosis ; Touch ; Upper extremity ; Upper Extremity - surgery</subject><ispartof>Archives of physical medicine and rehabilitation, 2013-11, Vol.94 (11), p.2179-2185</ispartof><rights>American Congress of Rehabilitation Medicine</rights><rights>2013 American Congress of Rehabilitation Medicine</rights><rights>Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c444t-93a5d8f0d4dfa7d0a09bdac058c44cf14540370f1fc79b6da3dd44a159be24453</citedby><cites>FETCH-LOGICAL-c444t-93a5d8f0d4dfa7d0a09bdac058c44cf14540370f1fc79b6da3dd44a159be24453</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0003999313004565$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23796687$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>van Gils, Willemijn, MD</creatorcontrib><creatorcontrib>Reinders-Messelink, Heleen A., MSc, PhD</creatorcontrib><creatorcontrib>Smit-Klaij, Frida, MD, PhD</creatorcontrib><creatorcontrib>Bongers, Raoul M., MSc, PhD</creatorcontrib><creatorcontrib>Dijkstra, Pieter U., PhD</creatorcontrib><creatorcontrib>van der Sluis, Corry K., MD, PhD</creatorcontrib><title>Sensibility of the Stump in Adults With an Acquired Major Upper Extremity Amputation</title><title>Archives of physical medicine and rehabilitation</title><addtitle>Arch Phys Med Rehabil</addtitle><description>Abstract Objectives To compare the sensibility of the stump in adults with an acquired major upper extremity amputation with the sensibility of the unaffected side and with the corresponding body parts of healthy controls, as well as to relate the sensibility of the stump to daily functioning. Design A survey with matched controls. Setting A tertiary referral center. Participants A referred sample of patients (n=30) with an acquired upper extremity amputation, at least 1 year after amputation, and control subjects (n=30) matched for age, sex, and hand dominance were evaluated. Interventions Not applicable. Main Outcome Measures Three different modalities of sensibility were measured: (1) touch-pressure sensibility, tested using Semmes-Weinstein monofilaments; (2) stereognosis, detected using the Shape and Texture Identification test; and (3) kinesthesia. Daily functioning was assessed using the Upper Extremity Functional Status Module of the Orthotics and Prosthetics Users' Survey. Results The mean time ± SD since amputation was 20±17.8 years. Twenty patients used a prosthesis. The stump sensibility was similar to that of unaffected hands and tended to be less than that of unaffected arms ( P =.08). The patients using a prosthesis had significantly poorer touch-pressure sensibility in the stump compared with the nonusers ( P =.04). However, touch-pressure sensibility and stereognosis were worse in the patients than in controls ( P &lt;.001 and P =.03, respectively). Two patients were able to identify shapes using their stump. Kinesthesia of the shoulders and elbows did not differ between the affected and unaffected side. Moreover, daily functioning was not related to sensibility. Conclusions The touch-pressure sensibility in the stumps of patients using prostheses was poorer than the sensibility in nonusers, and remarkably, the unaffected extremities of the amputees were less sensitive than the extremities of the controls.</description><subject>Adult</subject><subject>Aged</subject><subject>Amputation</subject><subject>Amputation Stumps</subject><subject>Female</subject><subject>Humans</subject><subject>Kinesthesis</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Physical Medicine and Rehabilitation</subject><subject>Rehabilitation</subject><subject>Sensation</subject><subject>Stereognosis</subject><subject>Touch</subject><subject>Upper extremity</subject><subject>Upper Extremity - surgery</subject><issn>0003-9993</issn><issn>1532-821X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkc1rFTEUxYMo9rX6D7iQLN3MeDNJ5gNEeJRqhYqL16K7kEnu0Izz1SQjvv_eDK-6cKGry-Wec-D-DiGvGOQMWPm2z_Uy-rwAxnOQORTyCdkxyYusLti3p2QHADxrmoafkfMQ-rSWkrPn5KzgVVOWdbUjtwecgmvd4OKRzh2N90gPcR0X6ia6t-sQA_3q4j3VaTUPq_No6Wfdz57eLQt6evUzehw3935c1qijm6cX5Fmnh4AvH-cFuftwdXt5nd18-fjpcn-TGSFEzBqupa07sMJ2urKgoWmtNiDrdDcdE1IAr6BjnamatrSaWyuEZrJpsRBC8gvy5pS7-PlhxRDV6ILBYdATzmtQTIr0qZRl9X-pEIkHZ3WdpMVJavwcgsdOLd6N2h8VA7WBV73awKsNvAKpEvhkev2Yv7Yj2j-W36ST4N1JgAnID4deBeNwMmgTUhOVnd2_89__ZTeDm5zRw3c8Yujn1U8JtWIqFArUYat-a55xACFT7b8Aqceo_g</recordid><startdate>20131101</startdate><enddate>20131101</enddate><creator>van Gils, Willemijn, MD</creator><creator>Reinders-Messelink, Heleen A., MSc, PhD</creator><creator>Smit-Klaij, Frida, MD, PhD</creator><creator>Bongers, Raoul M., MSc, PhD</creator><creator>Dijkstra, Pieter U., PhD</creator><creator>van der Sluis, Corry K., MD, PhD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20131101</creationdate><title>Sensibility of the Stump in Adults With an Acquired Major Upper Extremity Amputation</title><author>van Gils, Willemijn, MD ; Reinders-Messelink, Heleen A., MSc, PhD ; Smit-Klaij, Frida, MD, PhD ; Bongers, Raoul M., MSc, PhD ; Dijkstra, Pieter U., PhD ; van der Sluis, Corry K., MD, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c444t-93a5d8f0d4dfa7d0a09bdac058c44cf14540370f1fc79b6da3dd44a159be24453</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Amputation</topic><topic>Amputation Stumps</topic><topic>Female</topic><topic>Humans</topic><topic>Kinesthesis</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Physical Medicine and Rehabilitation</topic><topic>Rehabilitation</topic><topic>Sensation</topic><topic>Stereognosis</topic><topic>Touch</topic><topic>Upper extremity</topic><topic>Upper Extremity - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>van Gils, Willemijn, MD</creatorcontrib><creatorcontrib>Reinders-Messelink, Heleen A., MSc, PhD</creatorcontrib><creatorcontrib>Smit-Klaij, Frida, MD, PhD</creatorcontrib><creatorcontrib>Bongers, Raoul M., MSc, PhD</creatorcontrib><creatorcontrib>Dijkstra, Pieter U., PhD</creatorcontrib><creatorcontrib>van der Sluis, Corry K., MD, PhD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of physical medicine and rehabilitation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>van Gils, Willemijn, MD</au><au>Reinders-Messelink, Heleen A., MSc, PhD</au><au>Smit-Klaij, Frida, MD, PhD</au><au>Bongers, Raoul M., MSc, PhD</au><au>Dijkstra, Pieter U., PhD</au><au>van der Sluis, Corry K., MD, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Sensibility of the Stump in Adults With an Acquired Major Upper Extremity Amputation</atitle><jtitle>Archives of physical medicine and rehabilitation</jtitle><addtitle>Arch Phys Med Rehabil</addtitle><date>2013-11-01</date><risdate>2013</risdate><volume>94</volume><issue>11</issue><spage>2179</spage><epage>2185</epage><pages>2179-2185</pages><issn>0003-9993</issn><eissn>1532-821X</eissn><abstract>Abstract Objectives To compare the sensibility of the stump in adults with an acquired major upper extremity amputation with the sensibility of the unaffected side and with the corresponding body parts of healthy controls, as well as to relate the sensibility of the stump to daily functioning. Design A survey with matched controls. Setting A tertiary referral center. Participants A referred sample of patients (n=30) with an acquired upper extremity amputation, at least 1 year after amputation, and control subjects (n=30) matched for age, sex, and hand dominance were evaluated. Interventions Not applicable. Main Outcome Measures Three different modalities of sensibility were measured: (1) touch-pressure sensibility, tested using Semmes-Weinstein monofilaments; (2) stereognosis, detected using the Shape and Texture Identification test; and (3) kinesthesia. Daily functioning was assessed using the Upper Extremity Functional Status Module of the Orthotics and Prosthetics Users' Survey. Results The mean time ± SD since amputation was 20±17.8 years. Twenty patients used a prosthesis. The stump sensibility was similar to that of unaffected hands and tended to be less than that of unaffected arms ( P =.08). The patients using a prosthesis had significantly poorer touch-pressure sensibility in the stump compared with the nonusers ( P =.04). However, touch-pressure sensibility and stereognosis were worse in the patients than in controls ( P &lt;.001 and P =.03, respectively). Two patients were able to identify shapes using their stump. Kinesthesia of the shoulders and elbows did not differ between the affected and unaffected side. Moreover, daily functioning was not related to sensibility. Conclusions The touch-pressure sensibility in the stumps of patients using prostheses was poorer than the sensibility in nonusers, and remarkably, the unaffected extremities of the amputees were less sensitive than the extremities of the controls.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>23796687</pmid><doi>10.1016/j.apmr.2013.05.025</doi><tpages>7</tpages></addata></record>
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source MEDLINE; Elsevier ScienceDirect Journals Complete; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals
subjects Adult
Aged
Amputation
Amputation Stumps
Female
Humans
Kinesthesis
Male
Middle Aged
Physical Medicine and Rehabilitation
Rehabilitation
Sensation
Stereognosis
Touch
Upper extremity
Upper Extremity - surgery
title Sensibility of the Stump in Adults With an Acquired Major Upper Extremity Amputation
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