Patient perspectives on benefits and risks of implantable interfaces for upper limb prostheses: a national survey

ABSTRACT

Objective: Patient perspectives on benefits and risks of implantable interfaces for prostheses are needed.

Methods: A telephone survey was administered to 808 Veterans. Multivariate logistic regression identified factors associated with willingness to consider surgery to restore touch and better movement control. Risk and benefit ratings were compared.

Results: 41.8% of unilateral and 40.6% of bilateral amputees were willing to consider surgery for touch; 49.0% were willing to consider surgery for control. Persons 65–75 years and >75 were 0.42 (p= 0.0009) and 0.19 (p< 0.0001) as likely as those 18–45 to consider surgery for touch, those with better mental health (MH) were 0.47 (p= 0.0005) as likely as those with worse, and those with infection etiology were 1.7 (p= 0.03) as likely as those without. Persons 65–75 and >75 were 0.28 and 0.12 as likely as those 18–45 to consider surgery for control (p’s<0.0001). Myoelectric users were 2.16 (p= 0.006) as likely as body-powered users and persons with better MH were 0.61 (p= 0.03) as likely as those with worse to consider surgery for control. Long-term risks were most unacceptable. Durability, comfort, and improved functional abilities were most important.

Conclusions: There is substantial interest in prosthetic interfaces to gain a sense of touch and greater movement control.

KEYWORDS:

• Haptic feedback
• patient perspectives
• prosthesis control
• upper limb prostheses

Author contributions

Linda Resnik: design, acquisition of funding, analysis, interpretation of data, drafting and revising manuscript, final approval of publication

Matt Borgia: design, data analysis and interpretation, drafting and revising manuscript, final approval of publication

Melissa Clark: design, data collection, data analysis and interpretation, drafting and revising manuscript, final approval of publication

Heather Benz: design, data analysis and interpretation, drafting and revising manuscript, final approval of publication

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose

Additional information

Funding

This paper was funded by the Office of the Assistant Secretary of Defense for Health Affairs, through the Orthotics and Prosthetics Outcomes Research Program Prosthetics Outcomes Research Award (W81XWH-16-2-0065) and the U.S Department of Veterans Affairs (VA RR&D, A2707-I and VA RR&D A9264A-S).