A Mixed-methods Study on Prosthesis Use Among Older Canadians With Lower-limb Amputations

Abstract

Background: The prevalence of lower-limb amputations (LLA) in older adults is increasing. Due to the substantial resources required for rehabilitation, there is growing interest in exploring prosthesis use as well as the factors that impact use for individuals with LLA.

Objectives: To examine how older adults, those over 50 years old, with a new LLA use their prostheses following rehabilitation and to identify factors that increase or decrease prosthesis use after discharge from a rehabilitation hospital.

Methods: The StepWatch Activity Monitor, the Prosthetic Profile of the Amputee Questionnaire, and a semi-structured interview were used to measure prosthesis use and factors affecting use at 12 weeks post-discharge from a rehabilitation hospital. Descriptive statistics were calculated for the quantitative data and the qualitative interviews were analyzed using the International Classification of Functioning and Disability.

Results: Two user profiles emerged from the 11 participants' use patterns. The Regular Users integrated their prosthesis into their lives, using it for various types of activities, while the Strategic Users wore their prosthesis to perform specific activities of daily and instrumental activities of daily living tasks. Body functions (e.g., pain), personal (e.g., feeling of independence), and environmental factors (e.g., home adaptations or social support) impacted prosthesis use.

Conclusions: The emergence of profiles suggests variability in how older adults with LLA use their prosthesis after rehabilitation. However, the factors affecting prosthesis use were similar between the profiles. Therefore, while it is important for rehabilitation teams to consider patients' individual needs when setting goals for prosthetic training, they must also consider common factors affecting prosthesis use.

Keywords: Amputation; Lower Limb Amputation; Older Canadians; Prosthesis; Prosthetist; Rehabilitation.

Figure 1:

Daily average number of steps on the prosthesis at T1 (black) and T2 (grey).

Figure 2:

Number of days that participants took steps with their prosthesis. Black represents days with no steps taken and grey represents days with steps taken.