Evaluating the effects of adaptive therapeutic climbing on the strength and well-being of patients with upper limb differences: A pilot study

Abstract

Purpose: This study aimed to determine the feasibility and potential impact of adaptive therapeutic climbing (TC) program as an intervention to improve both psychosocial health and hand function of children with congenital upper limb differences (CULDs).

Methods: Participants completed 6 weeks of 1-hour group adaptive TC sessions with pre- and post-participation functional tests of active and passive range of motion (ROM) and manual muscle testing as well as evaluations for psychosocial impact using the Questionnaire for Measuring Health-Related Quality of Life in Children and Adolescents, Perceived Life Satisfaction Scale, and Patient-Reported Outcomes Measurement Information System short forms. Feasibility outcomes of the program were also evaluated.

Results: Although seven children began the study, three children dropped out due to socioeconomic hardship related to attendance. Of the four that completed the study, two participants with symbrachydactyly (complete absence of one hand) demonstrated improvement in contralateral tip pinch and bilateral shoulder ROM. Active and passive ROM for shoulder flexion and abduction improved in all children by at least 20° bilaterally. Overall, mean psychosocial scores were similar among study participants and healthy peers. Participants consistently attempted more climbs and some even higher grade routes.

Conclusion: Adaptive TC programs are likely impactful and safe for children with CULD and may improve function and flexibility of affected and unaffected limbs. Obstacles preventing attendance affected families of lower socioeconomic status.