How do users define success with a lower limb prosthesis? A focus group study

Abstract

Purpose

In this study, we sought to examine how lower limb prosthesis users define success, what constructs they associate with success, and what barriers and facilitators contribute to achieving success.

Materials and methods

Purposively sampled lower limb prosthesis users were recruited to participate in a focus group study. Verbatim transcripts from focus groups were analyzed using inductive thematic analysis. Identified constructs were mapped to existing outcome measures, and a conceptual framework for success with a lower limb prosthesis was proposed.

Results

Thirty-one lower limb prosthesis users participated in one of five focus groups. Five themes were developed: keep moving forward, despite ups and downs; being able to live MY normal life and do the things I want to do with ease; learning what works for me and how to manage my prosthesis; only I can define my success; and what about my mental health? Several constructs that do not align with existing measures were identified, including prosthetic attention, grief/loss after amputation, and trust in prosthesis. Facilitators for success described by participants included peer connection, finding the right prosthetist, and mental health support.

Conclusions

According to lower limb prosthesis users, success must be patient-driven, individually defined, and continually reassessed.

IMPLICATIONS FOR REHABILITATION

• According to prosthesis users, success with a lower limb prosthesis should be patient-driven, individually defined, and continually reassessed.

• Lower limb prosthesis users described facilitators for success to include peer connection, finding the right prosthetist, mental health support, and access to appropriate prosthetic technology.

• Constructs described by lower limb prosthesis users as relating to success that are currently difficult to measure include prosthetic attention, grief/loss after amputation, prosthesis management, ability to blend in, and trust in the prosthesis.

Keywords:

• Artificial limbs
• amputation
• focus groups
• rehabilitation
• outcomes assessment

Acknowledgments

The authors would like to thank Dana Wilkie for her assistance with participant payments.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by an Orthotic and Prosthetic Foundation for Education and Research Grant.