Activity Limb Provision for Paediatric Amputees. Birmingham's Story – Our Race - 5 years on

Name: Chloe Farthing

E-mail: cfarthing@hotmail.co.uk

Occupation: Physiotherapist

Birmingham Community Healthcare Trust, UK

Other authors (name only, alphabetical order): Sue Barlow, Lauren Kay, Poorna Ramamurthy, Carly Scott, Andrew Sharpe, Cat Spencer.

ABSTRACT

Background: Since 2017 the NHS have been able to provide sports limbs to children who have had an amputation or were born with a limb deficiency. The aim of this new funding was to enable children to engage in physical activity and sports.

Aims/purpose: Currently there is very limited research into the impact of providing sports limbs for both children and their families. The aim of this service evaluation was to collect data comparing the child’s everyday prosthesis to their sports prosthesis.

Methods: 32 children with lower limb amputations or limb deficiency have been provided sports limbs by our center and therefore were included in the study. 5 of these children had bilateral prosthesis. At the delivery of the sports prosthesis outcome measures were completed on the child’s everyday prosthesis and sports prosthesis. The outcome measures included a timed 25m run, figure of 8 test and qualitative data collected from the child and family. These were repeated at 3 months and 12 months on the sports prosthesis.

Results: Improvements were seen in the outcomes for the sports prosthesis in comparison to the every day prosthesis. For children with unilateral prosthesis, there were improvements in both 25m run and figure of 8 tests at initial fitting. The 25m run showed statistically significant improvements (p=0.02). At 3 months there were statistically significant improvements in 25m run (p<0.01) and figure of 8 (p<0.01) in comparison to baseline. At 12 months there were statistically significant improvements in 25m run (p=0.01) and figure of 8 (p=0.03) in comparison to baseline. For children with bilateral prosthesis the numbers were too small to show statistical significance, however, the overall trend was improvement. Qualitative data from children and families showed positive themes such as: children were more confident, faster, ‘bouncy’, able to keep up with peers, more active, like the look of it/ looks ‘cool’. In contrast to this there was one child who preferred the look of the everyday prosthesis as they felt it looked ‘more normal’.

Conclusion: Providing sports prosthesis to children on the NHS has enabled children to participate in sport and activity with their peers and family. Improvements were observed immediately at initial fitting and sustained over 12 months. There are benefits for both unilateral and bilateral prosthetic users. Stronger statistical improvement anticipated as more patients reach 12 month review.