Abstract
Successful prosthetic rehabilitation is essential to improve the physical and mental outcomes of people with lower-limb amputation. Evaluation of prosthetic services from a prosthesis user perspective have been published and commissioned by the national bodies, however, the perspectives of clinicians working with service users during rehabilitation have not to date been sought. We sought to determine factors impacting lower-limb prosthetic rehabilitation from a clinician's perspective to inform studies focusing on prosthetic and socket design and fitting. Six clinician (2 prosthetists, 4 physiotherapists) interviewees were self-selected from a survey exploring issues and frustrations during lower-limb prosthetic rehabilitation. Semi-structured interviews explored the impactors on and frustrations with rehabilitation and the prosthetic socket. A thematic analysis was subsequently conducted to identify themes in the responses. Five themes were identified: Service Disparity, Body Impactors, Consequences of Ill-Fit, Prosthesis Irritants, and Limitations of Practice. Each theme, though distinct, relates to the others either as a cause or consequence and should be viewed as such. Addressing the themes will have benefits beyond the issues addressed but also expand into the other themes. This study provides an insight into the clinician perspectives on lower-limb prosthetic rehabilitation, which has not been formally documented to date.
Highlights
Successful prosthetic rehabilitation of people with lower-limb amputations is vital to their ability to live and function independently
This study aims to start to highlight the experiences of rehabilitation clinicians, and how they impact lowerlimb prosthetic rehabilitation
The thematic analysis gives an insight into the first-hand perspectives of clinicians involved in lower-limb prosthetic rehabilitation
Summary
Successful prosthetic rehabilitation of people with lower-limb amputations is vital to their ability to live and function independently. Some evaluation of prosthetic services from a prosthesis user perspective have been published in literature [1,2,3], and commissioned by the National Health Service (NHS) [4]. Issues such as the satisfaction and comfort with the prosthesis, difficulties with lifestyle adjustment and communication between clinicians and patients have been reported. Throughout rehabilitation, patients interact with various clinicians, including occupational therapists and surgeons, amongst others Most of their interactions will be with prosthetists, who prescribe and fit the prosthesis, and physiotherapists, who guide strength training and movement re-education.
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