Enabling factors related to prosthetic use by people with transtibial and transfemoral amputation

Abstract

Objective: To evaluate the frequency and extent of prosthetic use by people with lower limb amputation and identify factors that facilitate prosthetic use. Design and Setting: Five-year follow-up survey using the Prosthetic Profile of the Amputee (PPA) questionnaire and Diliman's mailing strategy. Subjects: Adults with unilateral transtibial and transfemoral amputation ( n = 396) who had completed a prosthetic training program. Main Outcome Measures: Frequency of prosthetic wear, in hours per week, and active prosthetic use for locomotion indoors and outdoors. Results: Eighty-five percent of the respondents (mean age 62.9 ± 15.9yrs) were prosthetic wearers; 53% used their prosthesis for locomotion indoors, and 64% outdoors. Ability to don the prosthesis ( p < .001), locomotor capabilities with the prosthesis ( p < .001), walking distances ( p < .001), automaticity of gait ( p < .05), and assistive devices used ( p < .001) were the main factors related to the three outcome measures. People with transfemoral amputation reported greater difficulties in donning their prosthesis ( p < .01) and a significantly higher rate of falls ( p < .001). Conclusion: The majority of people with lower limb amputation wear their prosthesis daily. With the exception of resources (prosthetic laboratory and means of transportation), all enabling factors investigated were significantly associated with the outcome measures.