A National Survey of Prosthesis Use in Veterans with Major Upper Limb Amputation: Comparisons by Gender

Resnik, Linda; Borgia, Matthew; Clark, Melissa A.

doi:10.1002/pmrj.12351

Cited by 15 publications

(30 citation statements)

References 29 publications

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“…A recent study of Veterans with upper limb amputation collected detailed data on prosthesis satisfaction. Results about satisfaction with prostheses, comparing satisfaction ratings of persons with unilateral and bilateral amputation, 15 and device satisfaction by gender 16 have been reported. However, these studies have not compared satisfaction by prosthesis configuration or examined the relationship between initial prosthesis training and device satisfaction.…”

Section: Introductionmentioning

confidence: 99%

Prosthesis satisfaction in a national sample of Veterans with upper limb amputation

Resnik

Borgia

Heinemann

et al. 2020

Prosthetics &Amp; Orthotics International

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Background: Many persons with upper limb amputation reject prostheses, and many are not satisfied with their devices. Research is needed to understand modifiable factors related to device satisfaction. Myoelectric devices with multiple degrees of freedom are now available; however, no studies have examined whether they lead to greater device satisfaction. Prosthetic training contributes to more skillful prosthesis use and greater likelihood of long-term use; however, the relationship between training and device satisfaction is unclear. Objectives: (1) To describe and compare satisfaction by prosthesis and terminal device type and (2) to identify factors associated with satisfaction. Study design: Cross-sectional study. Methods: Participants were 449 persons with unilateral upper limb amputation who used a prosthesis. Participants described their prostheses, prosthetic training, device repairs, visits to a prosthetist, and rated device satisfaction using two standardized measures (Trinity Amputation and Prosthesis Experience Scales Satisfaction scale and Orthotics and Prosthetics Users’ Survey - Client Satisfaction with Devices scale). Multivariate generalized linear regression models examined the relationship between prosthesis and terminal device type and satisfaction, controlling for covariates that were meaningful in bivariate analyses. Results: There were no differences in satisfaction by prosthesis type or terminal device degrees of freedom. Satisfaction was associated with receipt of training to use the initial prosthesis, amputation level, age, and race. Conclusion: No differences in satisfaction by device or terminal device type were observed. Worse satisfaction was associated with more proximal amputation level, younger age, and black race. The association between receipt of initial prosthetic training and device satisfaction points to the critical role of occupational or physical therapy in the early stages of prosthetic care. Clinical relevance Prosthetic satisfaction did not vary by device or terminal device degrees of freedom. Proximal amputation level, younger age, and black race were associated with lower prosthetic satisfaction. Receipt of initial prosthetic training was associated with greater device satisfaction, pointing to the critical role and lasting impact of early training.

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Section: Introductionmentioning

confidence: 99%

Prosthesis satisfaction in a national sample of Veterans with upper limb amputation

Resnik

Borgia

Heinemann

et al. 2020

Prosthetics &Amp; Orthotics International

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show abstract

“…2,19,21,25 The prosthesis-related reasons for never using or abandoning a prosthesis can also vary by gender, amputation type, amputation level, and prosthesis type. 28 Prosthesis weight, comfort, and cosmetic appearance tend to be higher priorities for women, whereas prosthesis functionality and durability have been found to be of greater importance to men. 30 Prosthesis fit and cosmetic appearance also tend to be of greater importance in those with ULA.…”

Section: Introductionmentioning

confidence: 99%

“…27,28 In addition, lower prosthesis satisfaction ratings, female gender, upper-limb body-powered prosthesis type, lower baseline prosthesis use, vascular amputation etiology, cardiac conditions, and issues involving the remaining limb have all been associated with higher rates of prosthesis abandonment. 18,22,26,[28][29][30] Prior studies involving veterans with both ULA and LLA found higher rates of prosthesis abandonment in Vietnam-era veterans, who are older, compared with veterans who served in Iraq and Afghanistan after 2001, 18,24 whereas other studies have reported an inconsistent association between increased age and prosthesis nonuse. 2,22 Prosthesis discontinuation most commonly results from issues related to either prosthesis comfort or functionality.…”

Section: Introductionmentioning

confidence: 99%

Prosthesis nonuse and discontinuation in United States veterans with major limb amputation: Results of a national survey

Webster

Borgia

Resnik

2023

Prosthetics &Amp; Orthotics International

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Background:Prosthesis use in persons with amputation can improve mobility and functional independence. Better understanding of the reasons for and outcomes associated with prosthesis nonuse is important to optimize function and long-term health in persons with amputation.Objectives:Study objectives were to describe the rate, reasons for, and factors associated with never using or discontinuing prosthesis use in United States (US) veterans with amputation.Study Design:Cross-sectional study design.Methods:The study used an online survey to assess prosthesis use and satisfaction in veterans with upper-limb and lower-limb amputation. Survey participation invitations were distributed by email, text message, and mail to 46,613 potential participants.Results:The survey response rate was 11.4%. After exclusions, an analytic sample of 3,959 respondents with a major limb amputation was identified. The sample was 96.4% male; 78.3% White, with mean age of 66.9; and mean of 18.2 years since amputation. The rate of never using a prosthesis was 8.2%, and the rate of prosthesis discontinuation was 10.5%. Functionality (62.0%), undesirable prosthesis characteristics (56.9%), and comfort (53.4%) were the most common reasons for discontinuation. After controlling for the amputation subgroup, the odds of prosthesis discontinuation were higher for those with unilateral upper-limb amputation, female gender, White race (compared with Black race), diabetes, above-knee amputation, and lower prosthesis satisfaction. Prosthesis satisfaction and quality of life were highest for current prosthesis users.Conclusions:This study adds new understanding regarding the rate and reasons for prosthesis nonuse in veterans and highlights the important relationship between prosthesis discontinuation and prosthesis satisfaction, quality of life, and satisfaction with life.

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“…Furthermore, repeated excessive upper body movements generate early fatigue and pain which naturally leads to overuse of the intact limb 4 , 5 . Multiple survey studies indicate that the dissatisfaction factor of upper limb prostheses has been attributed to limited function, control strategy, and having higher weight 6 – 9 . Especially to increase the functionality of the prosthetic devices, state-of-the-art prosthetic designs have been developed to restore lost limb functions with multiple active degrees of freedom (DoF) 10 – 12 .…”

Section: Introductionmentioning

confidence: 99%

A novel framework for designing a multi-DoF prosthetic wrist control using machine learning

Swami

Lenhard

Kang

2021

Sci Rep

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Prosthetic arms can significantly increase the upper limb function of individuals with upper limb loss, however despite the development of various multi-DoF prosthetic arms the rate of prosthesis abandonment is still high. One of the major challenges is to design a multi-DoF controller that has high precision, robustness, and intuitiveness for daily use. The present study demonstrates a novel framework for developing a controller leveraging machine learning algorithms and movement synergies to implement natural control of a 2-DoF prosthetic wrist for activities of daily living (ADL). The data was collected during ADL tasks of ten individuals with a wrist brace emulating the absence of wrist function. Using this data, the neural network classifies the movement and then random forest regression computes the desired velocity of the prosthetic wrist. The models were trained/tested with ADLs where their robustness was tested using cross-validation and holdout data sets. The proposed framework demonstrated high accuracy (F-1 score of 99% for the classifier and Pearson’s correlation of 0.98 for the regression). Additionally, the interpretable nature of random forest regression was used to verify the targeted movement synergies. The present work provides a novel and effective framework to develop an intuitive control for multi-DoF prosthetic devices.

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A National Survey of Prosthesis Use in Veterans with Major Upper Limb Amputation: Comparisons by Gender

Cited by 15 publications

References 29 publications

Prosthesis satisfaction in a national sample of Veterans with upper limb amputation

Prosthesis satisfaction in a national sample of Veterans with upper limb amputation

Prosthesis nonuse and discontinuation in United States veterans with major limb amputation: Results of a national survey

A novel framework for designing a multi-DoF prosthetic wrist control using machine learning

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