Abstract
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. 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. 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. 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. 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.
Highlights
In 2011, 7708 lower limb amputations (LLA) were performed in Canada, largely on individuals between the ages of 5074 (54.9%) due to complications from diabetes (65%).[1]
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
The emergence of profiles suggests variability in how older adults with lower-limb amputations (LLA) use their prosthesis after rehabilitation
Summary
In 2011, 7708 lower limb amputations (LLA) were performed in Canada, largely on individuals between the ages of 5074 (54.9%) due to complications from diabetes (65%).[1]. Quantitative studies have used activity monitors,[5,6] functional performance measures,[8,10] self-reported wear time,[7,8] and validated questionnaires[7,8,9,10] to measure prosthesis use, while qualitative studies focused more on the type of activities done with the prosthesis, quality of life, and the experience of the prosthesis users.[4,11,12,13,14] The quantitative studies measured prothesis use at different times ranging from discharge to 15 months after rehabilitation and their results varied both in terms of the quantity and quality of prosthesis use.[7,8,9,10,11,12,13,14] For instance, some studies found a declined of use[6,10] restricted functioning in mobility,[10] leisure and social role such as employment,[8,9] and limited autonomy outdoors while others[7,8] reported increase prosthesis use overtime and higher functioning in activities of daily living. 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
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