Quality of Life, Functional Performance, and User Satisfaction of Lower Limb Prosthesis Clients

Abstract

Limb loss is more common than many people realize. There are over two million people with amputated limbs in the United States and the numbers are expected to double in 2050. Despite the advances in prosthetic device technology, less attention is on the prosthetic clients’ perspective of their prosthetic rehabilitation experience. Limited information exists on lower limb prosthetic users’ satisfaction and the various constructs related to it. Considering the challenges of access to adequate care and the significant cost associated with prosthetic rehabilitation, the use of home-based virtual care has not been investigated as a feasible alternative. Therefore, the purpose of this project was to explore the relationship between different aspects of the prosthetic users’ experience and determine the feasibility of a virtual assessment of mobility at home. Study one examined the relationship between prosthetic device and service satisfaction, health-related quality of life, and functional movement in a diverse population of lower-limb prosthesis users. The results demonstrated that a reasonable number of civilian, veteran, and military lower limb amputees are not satisfied with their prosthesis and rehabilitation service. The reported prosthetic client discontent is linked to reduced mobility, balance confidence, fear of falling, and health-related quality of life. This suggests that measures aimed at improving amputees’ lower limb functional movements and balance may improve prosthetic client overall satisfaction. Study two investigated the relationship between patient perception of lower extremity function and a home-based virtual evaluation of mobility in lower-limb prosthesis clients. The results revealed a strong correlation between the lower limb amputee self-report of movement with prosthesis in the home environment and the virtual assessment of mobility by a clinician. This suggests that the virtual assessment modality is a feasible complement to in-person prosthetic rehabilitation visit. This project provides patient-centered feedback to inform lower limb prosthetic clients rehabilitation with improved clinical outcomes.