Factors Associated With Prosthesis Embodiment and Its Importance for Prosthetic Satisfaction in Lower Limb Amputees

Abstract

Perceptual integration of a prosthesis into an amputee's body representation, that is, prosthesis embodiment, has been proposed to be a major goal of prosthetic treatment, potentially contributing to the user's satisfaction with the device. However, insufficient knowledge about individual or prosthetic factors associated with prosthesis embodiment challenges basic as well as rehabilitation research. In the present study, hierarchical multiple regression analyses on prosthesis embodiment—as assessed with the recently introduced Prosthesis Embodiment Scale—were applied to the survey data of a large sample of prosthesis-using lower limb amputees, entering relevant objective-descriptive (i.e., unbiased characteristics of the amputation or the prosthesis) and subjective-evaluative variables (i.e., the amputee's perceptions related to the amputation or the prosthesis) as first- or second-level regressors, respectively. Significant regressors identified in these analyses together explained R2 = 36.3% of prosthesis embodiment variance in the present sample, with a lower level of amputation, less intense residual limb pain, more realistic visual appearance of the device, higher prosthetic mobility, and more positive valence of prosthesis-induced residual limb stimulations representing significantly associated factors. Using the identical set of regressors hierarchically complemented by prosthesis embodiment on measures of prosthetic satisfaction—as assessed with the Trinity Amputation and Prosthesis Experience Scales—revealed that prosthesis embodiment was significantly and positively associated with aesthetic as well as functional prosthesis satisfaction. These findings emphasize the importance of psychological factors for the integration of a prosthesis into the amputee's body representation, which itself represents a crucial factor associated with prosthesis satisfaction. The results might have important implications for future prosthetic treatment; however, replication of the findings in an independent sample is required, as well as sophisticated experimental designs in order to elucidate the causality of effects.

A Scoping Review of Pressure Measurements in Prosthetic Sockets of Transfemoral Amputees during Ambulation: Key Considerations for Sensor Design

“…Unfortunately, rehabilitation is especially difficult for transfemoral amputees, and research indicates that a high amputation level is associated with both prosthetic non-use and a decreased probability of remaining ambulatory [ 2 , 3 ]. Socket fit has been cited as one of the main factors affecting gait re-education, rehabilitation, and quality of life for amputees from the viewpoint of both amputees and clinicians [ 4 , 5 , 6 , 7 , 8 , 9 ]. Poor socket fit is the cause of at least one gait deviation, in people with lower limb amputation, which could be linked to premature long-term musculoskeletal degenerations [ 6 , 10 , 11 ].…”

Limb apparent motion perception: modification by tDCS, and clinically or experimentally altered bodily states

“…Notably, most individulas with a lower limb amputation wore their respective prostheses daily, and experienced high ownership of their prosthesis. Accumulating theoretical and empirical evidence suggest that the integration of a prosthesis into an amputee's body representation enhances prothesis use (Bekrater-Bodmann, 2021). Prosthesis use has been identified as a key factor in the development of alternative motor representations adapting to limb loss (van den Heiligenberg et al, 2018).…”

Mind over matter: Perceived phantom/prosthesis co-location contributes to prosthesis embodiment in lower limb amputees

“…The group had a mean (M) age of 57.24 years, with a standard deviation (SD) of 11.26; there were 70.9% male and 29.1% female participants (no non-binary or gender-diverse participants). The participants have already been included in a previous report on prosthesis embodiment (Bekrater-Bodmann, 2021) and served as initial sample to identify individuals with (PLA group) or without phantom limb awareness (noPLA group) (see below).…”