The Effect of Cognitive Strategy Intervention on the Occupational Performance of Individuals with an Upper Limb Amputation Using a Prosthesis

Matthew Sproats

Research output: ThesisMasters Thesis

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Abstract

Occupational therapy is the primary profession that provides individuals who have an amputation of the upper limb with training in how to use a prosthesis in everyday activities. Rejection rates for prosthetics is high and cognitive load has been identified as a factor in this rejection. This thesis outlines a study investigating how cognitive load affects the occupational performance of individuals with an amputation of the upper limb.
Traditional intervention programs for prosthetic use have focused on rote learning and prosthetic control, and have not included cognitive strategy training. This research is an in-depth case study of two adult men with transhumeral amputations who use a prosthesis. A client-centred, goal-directed intervention approach was implemented based on the Perceive, Recall, Plan and Perform (PRPP) System of Task Analysis: Assessment and Intervention. Changes in occupational performance were measured using ecologically based assessments of functional performance. Occupational performance was measured through task mastery, cognitive strategy use and motor performance using the PRPP System of Task Analysis: Assessment and Intervention and the Upper Limb Performance Assessment (ULPA). Client-centred goals were evaluated using the Goal Attainment Scale and the psychological measures of the Depression, Anxiety and Stress Scale (DASS) and the General Self-efficacy Scale were also used.
The PRPP Intervention provides a framework for intervention that addresses cognitive load and encourages generalisation. The results from the research study indicate that the PRPP Intervention improved task mastery and cognitive strategy use, which resulted in increased prosthetic use for both participants. All areas of the participants’ cognitive strategy had improved, but strategies in the Perform quadrant and the strategy of Flow were most critical. Client-centred goals were achieved and changes in the DASS and General Self-Efficacy were also noted.
The research findings of this study indicate that the PRPP Assessment and the ULPA are suitable assessments in determining the components of performance that impact on effective prosthetic use and for evaluating change following intervention.

Original languageEnglish
QualificationMaster of Philosophy
Awarding Institution
  • Charles Sturt University
Supervisors/Advisors
  • Nott, Melissa, Principal Supervisor
  • Ranka, Judy, Co-Supervisor
Award date01 Aug 2017
Publisher
Publication statusPublished - 2018

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