Relationship between degree of disability, usefulness of assistive devices, and daily use duration: an investigation in children with congenital upper limb deficiencies who use upper limb prostheses

Patterns of use of a myoelectric prosthesis in a cohort of children with transverse defects below the level of the elbow

BACKGROUND

Myoelectric prostheses have become the accepted standard of care for pediatric upper-limb amputees.

OBJECTIVES

To describe the clinical characteristics and patterns of prosthesis use and to analyze the changes that occur during the growth process of these patients.

STUDY DESIGN

This is a longitudinal retrospective study comparing the results of surveys carried out in 2015 and 2022.

METHODS

The variables measured included clinical and demographic characteristics, patterns of use, and satisfaction with the prosthesis.

RESULTS

Twenty-one patients with transverse defects were fitted with myoelectric prostheses. With increasing age, there was a statistically nonsignificant decrease in the duration of use and a decrease in the number of patients using the prosthesis for activities of daily living from 13 to 10 ( p = 0.045), with a 28% dropout rate, higher in patients with more distal defects.

CONCLUSIONS

Since 2015, we have observed a decrease in the number of hours of prosthesis use, while maintaining a high percentage of patients using the prosthesis.

Child Amputee Prosthetics Project-Prosthesis Satisfaction Inventory (CAPP-PSI): Validation of Italian Version in Children with Upper Limb Amputation

Background: The Child Amputee Prosthetics Project-Prosthesis Satisfaction Inventory (CAPP-PSI) is a comprehensive instrument designed to measure satisfaction across functionality, aesthetic, and service domains. This study aimed to translate, culturally adapt, and evaluate the psychometric properties of the CAPP-PSI in an Italian pediatric population. Methods: Following international guidelines, the CAPP-PSI was translated and culturally adapted. Internal consistency was evaluated using Cronbach's alpha, while test-retest reliability was assessed with intraclass correlation coefficients (ICCs). Construct validity was measured by analyzing correlations among subscales. Results: A total of 113 children with congenital or acquired upper limb amputation, accompanied by their parents, were recruited from the Bambino Gesù Children's Hospital in Rome. The Italian CAPP-PSI demonstrated excellent internal consistency (Cronbach's alpha = 0.913) and strong test-retest reliability (ICC = 0.966). Subscale correlations showed strong relationships between child and parent satisfaction (r = 0.724, p < 0.01) and parent satisfaction with service (r = 0.612, p < 0.01), while moderate correlations were observed between child satisfaction and service (r = 0.434, p < 0.01). Conclusions: The Italian version of the CAPP-PSI is a reliable and valid tool for assessing prosthetic satisfaction in pediatric populations. It provides valuable insights for clinicians and researchers, supporting patient-centered care and targeted improvements in prosthetic design and services. Future studies should explore longitudinal outcomes and the role of psychosocial factors in prosthetic acceptance.

Intellectual Characteristics in Children With Congenital Unilateral Upper Limb Deficiencies

Introduction Some children with motor disabilities show low cognitive levels. However, the influence of motor disabilities on children's intelligence remains to be fully elucidated. This study aimed to clarify the intellectual characteristics of children with upper limb deficiencies and the influence of upper limb impairments on intelligence. Methods The participants were 10 children from four to six years of age with congenital unilateral transradial or transcarpal limb deficiencies who received prosthetic interventions. The children's intelligence and adaptive behaviors, including motor skills, were examined using the Wechsler Preschool and Primary Scale of Intelligence and the Vineland Adaptive Behavior Scale, respectively. Results There were no significant characteristics or discrepancies in cognitive level in children with upper limb deficiencies. The Adaptive Behavior Composite Score of the Vineland Adaptive Behavior Scale was significantly positively correlated with the Full-Scale Intelligence Quotient of the Wechsler Preschool and Primary Scale of Intelligence. Conclusions The children with congenital limb deficiencies showed average cognitive levels. Expansion of adaptive behaviors, including appropriate complementation of disabilities, may promote intellectual development in children with motor disabilities.

Prenatal radiographic evaluation of congenital transverse limb deficiencies: A scoping review

BACKGROUND

Congenital transverse deficiencies are horizontal deficiencies of the long bones that occur with a reported incidence as high 0.38%. They can occur alone or represent a manifestation of a various clinical syndromes. Diagnosis has traditionally comprised of conventional radiography and prenatal imaging studies. There has been much advancement regarding prenatal imaging modalities to allow for early diagnosis and appropriate treatment.

AIM

To summarize the current state of knowledge on congenital transverse limb deficiencies and to provide an update regarding the radiographic evaluation of congenital transverse limb deficiencies.

METHODS

This IRB-exempt scoping review followed the PRISMA-ScR checklist for scoping reviews strictly. Five search engines were searched for a total of 265 publications. Four authors reviewed these during the screening process. Of these, 51 studies were included in our article. Prenatal magnetic resonance imaging (MRI), 3D Ultrasound, and multidetector Computed tomography (CT) exist are emerging modalities that have the potential to improve diagnosis.

RESULTS

Use of the appropriate classification system, three-dimensional ultrasonography with a maximum intensity projection, and appropriate use of prenatal MRI and prenatal CT can improve diagnosis and inter-provider communication.

CONCLUSION

Further scholarly efforts are required to develop improve standardized guidelines regarding the pre-natal radiographic evaluation of congenital limb deficiencies.