Activity and Participation, Bimanual Function, and Prosthesis Satisfaction are Strong Predictors of General Well-Being Among Upper Limb Prosthesis Users

Abstract

ObjectiveTo determine the role of multiple factors on general well-being for upper limb prosthesis users. DesignRetrospective cross-sectional observational design. SettingProsthetic clinics across the United States. ParticipantsAt the time of analysis, the database consisted of 250 patients with unilateral upper limb amputation seen between July 2016 and July 2021. InterventionNot applicable. Main Outcomes MeasuresDependent variable: well-being (Prosthesis Evaluation Questionnaire- Well-Being). Independent variables included in analysis: activity and participation (Patient Reported Outcomes Measurement Information System [PROMIS] Ability to Participate in Social Roles and Activities), bimanual function (PROMIS-9 UE), prosthesis satisfaction (Trinity Amputation and Prosthesis Experience Scales-Revised; TAPES-R), PROMIS pain interference, age, gender, average daily hours worn, time since amputation, and amputation level. ResultsA multivariate linear regression model using a forward enter method was applied. The model included 1 dependent variable (well-being) and 9 independent variables. Within the multiple linear regression model, the strongest predictors of well-being were activity and participation (β=0.303, P<.0001), followed by prosthesis satisfaction (β=0.257, P<.0001), pain interference (β=-0.187, P=.001), and bimanual function (β=0.182, P=.004). Age (β=-0.036, P=.458), gender (β=-0.051, P=.295), time since amputation (β=0.031, P=.530), amputation level (β=0.042, P=.385), and hours worn (β=-0.025, P=.632) were not significant predictors of well-being. ConclusionReducing pain interference and improving clinical factors such as prosthesis satisfaction and bimanual function with their associated effects on activity and participation will positively affect the well-being of individuals living with upper limb amputation/congenital deficiency.