The Effects of Prosthesis Use Versus Non-Use on Forward Reach
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Grand Valley State University ScholarWorks@GVSU Masters Theses Graduate Research and Creative Practice 1999 The ffecE ts of Prosthesis Use Versus Non-use on Forward Reach Distance in Children Ages 5 to 15 with Unilateral Upper Extremity Amputation as Measured by the Functional Reach Test Mary E. Weber Grand Valley State University Follow this and additional works at: http://scholarworks.gvsu.edu/theses Part of the Physical Therapy Commons Recommended Citation Weber, Mary E., "The Effects of Prosthesis Use Versus Non-use on Forward Reach Distance in Children Ages 5 to 15 with Unilateral Upper Extremity Amputation as Measured by the Functional Reach Test" (1999). Masters Theses. 346. http://scholarworks.gvsu.edu/theses/346 This Thesis is brought to you for free and open access by the Graduate Research and Creative Practice at ScholarWorks@GVSU. It has been accepted for inclusion in Masters Theses by an authorized administrator of ScholarWorks@GVSU. For more information, please contact [email protected]. The Effects of Prosthesis Use Versus Non-use on Forward Reach Distance in Children Ages 5 to 15 with Unilateral Upper Extremity Amputation as Measured by the Functional Reach Test by Mary E. Weber Scot G. Smith THESIS Submitted to the Physical Therapy Program at Grand Valley State University Allendale, Michigan in partial MGHment o f the requirements for the degree of MASTER OF SCIENCE IN PHYSICAL THERAPY 1999 THESIS COMMITTEE APPROVAL: H U U u Chair; Mary/^. Green, M.S., P.T. .v ü fa i. Mi rn y i.LiitLMi : Je m ^ r McWain, M.S., P.T. The Effects of Prosthesis Use Versus Non-use on Forward Reach Distance in Children Ages 5 to 15 with Unilateral Upper Extremity Amputation as Measured by the Functional Reach Test ABSTRACT The purpose o f this study was to investigate the possible differences in maximal forward reaching distance in children with unilateral upper extremity amputations while wearing and not wearing a prosthesis using the Functional Reach (FR) test. Trends were noted between FR scores of these children and children without disabilities. Four children, ages 5-8, completed the FR test using the intact arm under two conditions, “prosthesis-off” and “prosthesis-on”. A paired, two-tailed t test (a = .05) was used to determine the statistical significance of the means o f differences in FR scores between the two conditions. No statistically significant difference was found in the FR test scores between the two conditions noted above. Two trends were observed: 1) 3 of 4 subjects reached forther in the “prosthesis-off' condition and 2) 3 of 4 subjects attained a FR score within the 95% Cl range described by other researchers for children without disabilities. ACKNOWLEDGMENTS The authors would like to express appreciation to the following individuals: Committee chair: Mary N. Green, M S., P.T. o f Grand Valley State University, Allendale, Michigan Committee members: Jennifer McWain, M.S., P.T. o f Mary Free Bed Hospital and Rehabilitation Center, Grand R^ids, Michigan Theresa Bacon-Baguley, Ph.D., R.N. of Grand Valley State University, Allendale, Michigan Statistics support: Associate Professor Winson Taam of Oakland University, Rochester, Michigan Professor Alvema Champion, Ph.D. of Grand Valley State University, Allendale, Michigan Assistant Professor Justine Ritchie, Ph.D. o f Grand Valley State University, Allendale, Michigan Karen Switek of Valparaiso University, Valparaiso, Indiana Proof readers: Janet M Shy-Campbell and Sally VanDenburg Thank you to Grand Valley State University Human Subjects Review Board and the GVSU Physical Ther^y Department feculty and staff. The authors also wish to acknowledge the cooperation and support of those working with Mary Free Bed Hospital and Rehabilitation Center and the Area Child Anqjutee Clinic of Grand Rapids, Michigan: Barb Kaniewski, OTR, Char Greer, MPH, Dr. Charles Bukrey, Dr. Raymond Lovett, Ms. Barbra G. White, Ms. Ellen Ballard, Ph-D. and Dr. John Butzer. A special thanks to the femilies and children who volunteered for this study. ii TABLE OF CONTENTS ABSTRACT..................................................................................................................... i ACKNOWLEDGMENTS................................................................................................ ü LIST OF TABLES........................................................................................................... v LIST OF FIGURES......................................................................................................... vi LIST OF APPENDICES.................................................................................................vü Chapter 1. INTRODUCTION .......................................................................................... 1 Background .......................................................................................................... 1 Statement of Problem ............................................................................................2 Purpose of Study ...................................................................................................2 Significance .......................................................................................................... 2 Null Hypothesis .................................................................................................... 4 Chapter 2. UTERATURE REVIEW ............................................................................... 5 Upper Extremity Anq>utations ............................................................................... 5 Prosthetics ............................................................................................................ 8 Functional Measures of Prosthetic Use .................................................................. 11 Postural Control .................................................................................................. 13 Aspects of Postural Control ..................................................................................14 Upper Extremity Function and Postural Control.....................................................15 Upper Extremity Ançutatk>ns, Prostlœses, and Postural Control ...........................21 Postural Control and Falls .................................................................................... 23 Balance Inqiairments in Children .......................................................................... 24 Clinical Pediatric Balance Tests ............................................................................ 24 Functk)nal Reach Test ......................................................................................... 27 Summary and In^lications ................................................................................... 34 Chapter 3. METHODS .................................................................................................. 36 Study Design...................................................................................................... 36 S tu ^ Site and Subjects ....................................................................................... 36 Instrumentation and Equqtment ............................................................................38 m Validity and ReM nlity.........................................................................................39 Procedure ............................................................................................................ 40 Chapter 4. DATA ANALYSIS .......................................................................................42 Data Analysis of Pilot Study .................................................................................42 Characteristics of Subjects .................................................................................... 42 Data Analysis of “Prosthesis-ofiE” versus “Prosthesis-on” Conditions ..................... 43 Findings of Interest ...............................................................................................47 Trends in Distance Reached Under Two Conditions ................................... 47 Conq)arison to Donahoe et aL D ata ........................................................... 47 Chapter 5. DISCUSSION AND IMPUCATIONS ...........................................................49 Discussion of Findings .......................................................................................... 49 Conçarison of “Prosthesis-off ’ to “Prosthesis-on” Conditions ...................49 Conqxarison of FR Scores to Subjects without Disabilities .......................... 52 Applkations to Chnkal Physical Therapy Practice ................................................. 53 Limitations ...........................................................................................................54 Test Instrument ........................................................................................ 54 Study Design............................................................................................56 Strengths ............................................................................................................. 58 Suggestions for Further Research and Possible Modifications to this Study ............59 Conclusion ...........................................................................................................60 REFERENCES............................................................................................................... 61 APPENDICES...............................................................................................................