Stakeholder perspectives for possible residual limb monitoring system for persons with lower-limb amputation

Abstract

Purpose: To gather ideas from lower-limb prosthesis users and certified prosthetists regarding possible residual limb monitoring system features and data presentation. We also gathered information on the type of residual limb problems typically encountered, how they currently manage those problems, and their ideas for methods to better manage them.

Materials and methods: Two focus groups were held; one with certified prosthetists and another with lower-limb prosthesis users. Open-ended questions were used in a moderated discussion that was audio recorded, transcribed, and assessed using applied thematic analysis.

Results and conclusions: Seven individuals participated in each focus group. Prosthetists came from a mix of practice settings, while prosthesis users were diverse in level of amputation, aetiology, and years of experience using lower-limb prostheses. Residual limb problems reported by participants were consistent with those in the literature. Participants suggested better managing residual limb problems through improved education, better detection of residual limb problems, and using sensor-based information to improve prosthetic technology. Participants favoured short-term use of a possible residual limb monitoring systems to troubleshoot residual limb problems, with temperature and pressure the most frequently mentioned measurements. Participants described that an ideal residual limb monitoring system would be lightweight, not interfere with prosthesis function, and result in benefits with regard to prosthetic care and socket function that outweighed inconveniences or concerns regarding system use. A potential positive of system use included having objective data for reimbursement justification, although it was pointed out that the residual limb monitoring system itself also needed to be reimbursable.

Implications for Rehabilitation

• Stakeholders suggested better managing residual limb problems through improved education, better detection of residual limb problems, and using sensor-based information to improve prosthetic technology.

• Stakeholders favored short-term use of a possible system to troubleshoot residual limb problems, with temperature and pressure the most frequently mentioned measurements.

• Stakeholders described that an ideal residual limb monitoring system would be lightweight, not interfere with prosthesis function, and result in benefits with regard to prosthetic care and socket function that outweighs any inconveniences or concerns regarding system use.

• Stakeholders indicated that a potential positive of system use included having objective data for reimbursement justification, although it was pointed out that the residual limb monitoring system itself also needed to be reimbursable.

Keywords:

• Lower-limb prosthesis
• residual limb monitoring
• focus groups
• prosthetic interface
• amputation rehabilitation

Acknowledgements

The authors thank Dr. RJ Garrick for help in moderating the focus groups and providing transcription, and Piper Kruse for audio recording.

Disclosure statement

The authors report no declarations of interest.

Additional information

Funding

This work was supported by the Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD) and the National Institute of Biomedical Imaging and Bioengineering (NIBIB) under grant R01EB019337.