Introduction: In children with upper limb reduction deficiency (ULRD) scoliosis has been reported but the development of these spinal deviations over time is unclear. Furthermore, little is known about the development of other upper body structures and potential physical complaints in this population. Also, the influence of prosthesis use on the development of body structures or complaints is unknown.
Aim: To describe upper body structures of persons with unilateral ULRD and the development of these structures over time, to examine the presence of physical complaints in this population, and to study the effect of prosthetic use on body structures and physical complaints.
Method: A prospective cohort study with a follow-up period of 24 years was conducted. Twenty-eight persons (age 8-18 years at inclusion) with ULRD and 62 matched controls underwent measurements of upper-arm, trunk and spine and answered study-specific questionnaires at baseline and follow-up. In addition, at follow-up the Brief Pain Inventory and the Quick Disability of Arm, Shoulder and Hand questionnaires were answered.
Results: Within-subject differences in structures of the arm and trunk were shown in patients but not in controls both at baseline and follow-up. Spinal deviations were greater in patients compared to controls. No structural scoliosis was found. Self-reported disability was higher in patients compared to controls. Differences in back pain and effects of prosthesis use could not be detected.
Discussion: The structural within-person difference between body-halves may explain the findings of spinal deviations. The rates of physical complaints were remarkably low, compared to other studies. This might be due to differences between persons with ULRD and acquired upper limb amputations, level of deficiency, prosthetic use or age.
Conclusions: Persons with ULRD have consistent differences in upper body structures over time. Deviations of the spine, probably of functional origin, do not proceed to clinically relevant scoliosis.
2013.
ISPO 2013 World Congress - Inclusion, Participation & Empowerment, Hyderabad, India, 4-7 February, 2013.