Occupation

Abstracts Tuesday 28 June 2016
WHITEHEAD, PJ, UMMOND, AER, WALKER, MF, PARRY, RH,
MCGEORGE, ID and LATIF, Z, 2014. Occupational Therapy in
HomEcare Re-ablement Services (OTHERS): study protocol for a
randomized controlled trial Trials. 15, 447
Keywords
Social Care, Research, Practice – present and future, Social Care
Contact E-mail Addresses
phillip.j.whitehead@nottingham.ac.uk
Author Biographies
Phillip Whitehead is an NIHR Doctoral Research Fellow at the
University of Nottingham. For his doctoral research he completed
a programme of work on Occupational Therapy in Re-ablement”
encompassing: a systematic review qualitative interview study
and feasibility RCT. Before working in research he was as an
occupational therapist in social care in a variety of different roles.
Trauma and Orthopaedics Annual Conference
Session 12.1
Correlating an amputee specific and a generic
outcome measure, for myoelectric prosthetic users
Jacobs M, St Georges University of London
Background: The upper limb amputee population in the UK
is small and the majority of patients are treated on the NHS.
Myoelectric prostheses are a popular choice for this client group
as they combine function with the appearance of a hand.
However, costs and rejection rates of these prostheses are high.
More widespread use of standardised measures to evaluate
prosthetic outcomes would benefit clinical decision making.
Yet, the evidence base relating to outcome measures for this
population is limited. Furthermore, only one assessment has
been designed and validated specifically for use with myoelectric
prostheses – The Assessment of Capacity for Myoelectric Control
(ACMC). Previous studies have identified generic manual
dexterity assessments, such as the Box and Blocks, as having
potential for use with this client group (Wright, 2009).
Aim: To amend the Box and Blocks assessment for myoelectric
prosthesis users and correlate scores from the amended and
standard version, with the ACMC.
Methods: Relevant ethical and trust approvals were obtained.
Participants completed the ACMC, standard and amended Box
and Blocks on two occasions, two months apart. Scores were
correlated between the standard Box and Blocks and ACMC,
amended Box and Blocks and ACMC and the standard and
amended Box and Blocks.
Results: 14 Participants were recruited. Correlations were as
follows: Amended Box and Blocks v’s ACMC r=0.69, Standard
Box and Blocks v’s ACMC r=0.79, Standard v’s Amended Box
and Blocks r=0.93. The combined p–value was =0.238. This
study was underpowered.
Conclusion: The correlations observed were strong. However,
the difference between the standard and amended Box and
Blocks was not statistically significant. The results support the
existing literature regarding the potential of the Box and Blocks
assessment with prosthesis users. However, further research with
a larger sample size is indicated.
Keywords
Adult physical health, Research, Upper Limb Prosthetic Outcome
Measures.
References
Wright, V. (2009) ‘Prosthetic outcome measures for use with
upper limb amputees: a systematic review of the peer-reviewed
literature, 1970 to 2009’, Journal of Prosthetics and Orthotics,
21 (4S), pp. 3–63.
Keywords
Adult physical health, Research, Practice – present and future,
NHS
Contact E-mail Addresses
melissa.jacobs@stgeorges.nhs.uk
Author Biographies
Melissa Jacobs is an occpuational therapist and has been
working in Amputee Rehabilitation since 2009.
Session 12.2
The impact of partial hand amputation – a case
study
Barker L, North East London Foundation Trust (NELFT)
Partial hand amputation can impact on all aspects of an
individual’s well-being, quality of life and occupation. The loss
of a hand, because of its highly symbolic and multi-functional
nature, is known to be more traumatic than the loss of a leg
(Rybarczyk B et al 2008).
This presentation will explore, through a case study, the impact
of traumatic partial hand amputation on an individual and
explore the types of prosthesis provided. The presentation will
include the individual’s progress through their journey following
injury and amputation, describing occupational therapy
intervention, and a multi-disciplinary approach.
Occupational performance outcomes will be presented using the
Canadian occupational performance measure (Law et al 2014).
The clinical reference group for complex disability, equipment
– prosthetics (2013) refers to the impact that the appearance a
prosthesis may have on the successful prosthetic rehabilitation of
a patient. It is currently difficult for clinicians to obtain funding
for a high definition silicone prosthesis, and it is anticipated that
this presentation will highlight the effect of amputation on body
image and the importance of providing a realistic and acceptable
prosthesis to the individual. It will be discussed that this in turn
may have a positive influence on an individual’s occupational
performance.
References
Rybarczyk B, Behel J (2008) Psychoprosthetics Chapter 3 – Limb
Loss and Body Image Chapter 3 pg24 Springer
Law M, Baptiste S et al (2014) Canadian Occupational
Performance Measure 5 th Edition Canadian Association of
Occupational Therapy ACE Publications
NHS England Clinical Reference Group for Complex Disability,
Equipment – Prosthetics (2013) Clinical Commissioning Policy:
Provision of custom made high definition silicone covers for
prosthetic limbs and partial hand prostheses Reference NHSCB/
DO1/S/d NHS England
Keywords
Adult physical health, Practice development, Interdisciplinary
practice, NHS
Contact E-mail Addresses
lindsey.barker@nelft.nhs.uk
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