Preliminary outcomes: multi-articulating hands and digits, toe-to-hand and hand transplants

CHICAGO — Diane Atkins, OTR, FISPO, presented preliminary results of a study which compared the function of electric multi-articulating hands and digits, toe-to-hand transfers and hand transplantations at the American Academy of Orthotists and Prosthetics Annual Meeting and Scientific Symposium, here.

“An independent and experienced occupational therapist has performed all of these assessments in exactly the same manner on all of the subjects,” Atkins said. “That is the constant and that is critically important in the study.”

The study included 26 total patients: 15 amputees with multi-articulating hands and digits, six individuals with toe-to-hand transfers, four individuals with bilateral hand transplants and one individual with a unilateral hand transplant.


Diane Atkins

In a timed test with eight abstract objects and 14 activities of daily living, designed to study eight different prehensile patters of grasp, the unilateral hand scored highest, whereas the bilateral prostheses scored lowest.

The bilateral hand transplant patients displayed the greatest perception of disability, whereas the toe-to-hand subjects demonstrated the lowest.

For individuals with hand transplants, findings showed the psychological screen prior to transplantation, patient compliance with immunosuppression drugs and therapy for up to 2 years, was critically important post-transplantation.

With advances in hand transplantation surgery and emerging technological advances, the study aims to build bridges of understanding, enable an individual who has lost a hand to make informed decisions regarding care and define success in a way that is meaningful and understood by both the doctor and patient, Atkins said.

Future considerations include times, costs, amount of therapy required, medications and potential complications. — by Shawn Carter

For more information:

Atkins D. Paper F5. Presented at: American Academy of Orthotists and Prosthetists Annual Meeting. Feb. 26-March 1, 2014. Chicago.

Disclosure: Atkins has no relevant financial disclosures.

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