Developing consensus on important factors associated with lower limb prosthetic prescription and use

Abstract

Purpose: There is an ongoing concern in lower limb prosthetic rehabilitation with underuse and nonuse of prosthetic technology. The aim of this study was to gather expert opinion on the most important outcomes, predictors and facilitators of lower limb prosthetic prescription and use, with a long-term goal of improving satisfaction with prosthetic technology. Method: An electronic Delphi study was conducted using an expert panel of 21 service providers and users and was undertaken over three iterations. Results: The process resulted in the identification of 13 outcomes, 19 predictor and 34 facilitator factors. Conclusions: Psychosocial factors related to service provision and prosthetic use have not been widely recognized or incorporated into clinical practice. We highlight the need for creating standardized measures that incorporate psychosocial factors and that can contribute to a broadly applicable evidence base for optimal prosthetic prescription.

Implications for Rehabilitation

• A key component of the rehabilitation process of persons with lower limb amputation is the prescription of a prosthesis.

• Nonuse and underuse of prosthetic technology is of increasing concern.

• This research aims to improve the quality of life for people with lower limb amputation by developing consensus on important outcomes, predictors and facilitators of lower limb prosthetic prescription and use.

• These findings emphasize the importance of psychological and social factors when considering prosthetic prescription and use and are an important step in informing the tailoring and evaluation of interventions to facilitate the use of a prosthesis, the delivery of services and appropriate outcome measurement.

Keywords::

• Lower limb amputation
• prosthetic
• psychosocial factors

Acknowledgments

The authors greatly appreciate the contribution of all those who participated in the Delphi study.

Declaration of Interest: This research was funded with a grant from the Health Research Board, Ireland. Grant Number RP/2006/103.