A survey of the frequency of problems associated with overuse among people with acquired or congenital unilateral upper-limb loss found that the most frequent overuse problem was carpal tunnel syndrome, followed by shoulder pain, neck pain, and elbow pain. The study found no statistically significant association between limb-loss level, cause of limb loss, time since limb loss, extent of daily prosthesis use, or type of prosthesis and frequency or severity of pain or number of problems. The presence of carpal tunnel syndrome decreased among participants who did not use prostheses, through those who used aesthetic and body-powered prostheses, to those who used myoelectric prostheses. The study was published online before print May 28 in Prosthetics and Orthotics International.
The cross-sectional study was conducted at the subspecialist outpatient clinic of the University Rehabilitation Institute, Ljubljana, Slovenia. The cohort included 65 people with unilateral upper-limb loss who visited the clinic during 2011-2013 for overuse-type problems that did not have other possible medical causes. The participants were interviewed about the frequency, duration, and severity of neck, elbow, and shoulder pain and the presence of carpal tunnel syndrome, and completed the Upper Extremity Functional Status module of the Orthotics and Prosthetics User Survey.
The study’s authors concluded that overuse problems after upper-limb loss are not straightforward and recommended that a large, multicentric study is warranted to clarify the factors that contribute to overuse among people with acquired or congenital unilateral upper-limb loss, and that regular individual follow-up be conducted until the contributing factors are determined.