Understanding decision-making in prosthetic rehabilitation by prosthetists and people with lower limb amputation: a qualitative study

Anderson, Chelsey B; Kittelson, Andrew J; Wurdeman, Shane R.; Miller, Matthew J.; Stoneback, Jason W; Christiansen, Cory L.; Magnusson, Dawn

doi:10.1080/09638288.2022.2037745

Cited by 5 publications

(5 citation statements)

References 45 publications

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“…8 Additionally, health professionals that express their understanding and empathy with the focus on the patient, increase patient trust and contribute to positive experiences with physical therapy and prosthetic management. 4 , 9 These findings are consistent with our study where participants related the importance of collaboration as a means to support healthy therapeutic relationships.…”

Section: Discussionsupporting

confidence: 91%

“…The therapeutic alliance defines a shared trust and collaboration between the patient and the healthcare practitioner, 6 and can be promoted through collaboration, communication, and personalized care for individuals with limb loss. 4 , 7 The core of the therapeutic alliance is a patient-centered approach, a finding that is evident from the qualitative portion of this study. For example, patients who are engaged in decision-making for cosmetic design of the prosthesis felt empowered and had greater satisfaction with their prosthesis.…”

Section: Discussionmentioning

confidence: 66%

“… 3 Research has shown the importance of the collaborative decision-making process between prosthetists and individuals with limb loss and the positive impact it has on patient-centered outcomes. 4 This synergistic process was echoed for PT's, with collaborative goal setting and problem-solving being of importance to the rehabilitation process. 5 …”

Section: Introductionmentioning

confidence: 99%

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The Ideal Physical Therapist From the Perspective of Individuals With Limb Loss

Lee,

Albert Gambale,

Maya Nisani

et al. 2023

Can. Prosthet. Orthot. J.

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BACKGROUND: Effective rehabilitation after limb loss is necessary to maximize function and promote independence. Physical therapists (PT) are one of the primary drivers of the rehabilitation process. While general physical therapy knowledge and abilities have been shown to be important to the rehabilitation process, it is unclear what individuals with limb loss value in their PT’s. OBJECTIVE: The purpose of this study was to understand the elements that define an ideal PT from the perspective of individuals with limb loss. METHODOLOGY: Mixed-method design consisting of a 20-item web-based survey and semi-structured interviews that were administered to individuals 18 years or older, who spoke English, and had a history of lower limb loss. FINDINGS: Individuals with limb loss describe an ideal PT as promoting a therapeutic alliance, having specialized knowledge, and collaborating with a prosthetist. Knowledge of the PT as it relates to limb loss was found to be both the greatest facilitator and barrier to the rehabilitation process. CONCLUSION: From the perspective of those with limb loss, an ideal PT promotes a strong therapeutic alliance through communication, has specialized knowledge when it comes to the limb loss rehabilitation process, and collaborates with the prosthetist to problem-solve throughout the rehabilitation process. Layman's Abstract Individuals with limb loss require specialized care from a variety of health care providers to maximize function and mobility. Rehabilitation is generally administered by physical therapists along with other members of the medical team, including prosthetists. Physical therapists have generalized knowledge about limb loss management, however, there is limited access to physical therapists who are specialized in this area. It is not understood if the lack of specialization is a concern for individuals in the limb loss community. Therefore, our study explored what individuals with limb loss would define as the ideal physical therapist. We reviewed responses from surveys and interviews from individuals with limb loss and found that they value the specialized knowledge of the physical therapist, as well as the therapeutic relationship between themselves, the physical therapist, and the prosthetist. Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/42093/32281 How To Cite: Lee D.J, Gambale A, Nisani M, Miller C, Leung E, Rodgers M, et al. The ideal physical therapist from the perspective of individuals with limb loss. Canadian Prosthetics & Orthotics Journal. 2023; Volume 6, Issue 1, No.4. https://doi.org/10.33137/cpoj.v6i1.42093 Corresponding Author: Daniel J. Lee, PhD Department of Physical Therapy, Stony Brook University, Stony Brook, NY, USA. E-Mail: daniel.lee.8@stonybrook.edu ORCID ID: https://orcid.org/0000-0003-1805-2936

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 66%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Ideal Physical Therapist From the Perspective of Individuals With Limb Loss

Lee,

Albert Gambale,

Maya Nisani

et al. 2023

Can. Prosthet. Orthot. J.

View full text Add to dashboard Cite

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“…From the prosthetist’s perspective, patients may not want to discuss things that they do not fully understand. However, it was further indicated that patients would feel more engaged with a thorough discussion about all prosthesis design options, 29 which aligns with the findings of this study. Strategies to facilitate informed decision making among treatment options may include a step-by-step explanation of DT or providing visual aids, such as pamphlets and videos.…”

Section: Discussionsupporting

confidence: 84%

“…is limited. 29 Prosthetists sometimes make design decisions themselves because of the multifaceted considerations regarding component selections that may be complex and too technical to explain to a patient who is unfamiliar with the process. From the prosthetist’s perspective, patients may not want to discuss things that they do not fully understand.…”

Section: Discussionmentioning

confidence: 99%

User perspectives of digital manufacturing for lower-limb prosthetic sockets

Phillips,

Li,

Miguel

et al. 2023

Prosthetics &Amp; Orthotics International

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Background: There is growing interest to use digital technology (DT) for manufacturing lower-limb prosthetic sockets to improve efficiency and clinical outcomes. However, little is known about how lower-limb prosthesis users perceive DTs, such as 3D scanning and 3D printing. Objectives: This study aimed to provide an understanding of perceptions and experiences with DT for prosthetic socket manufacturing from the perspective of prosthesis users. Study design: A qualitative descriptive research study. Methods: Nine lower-limb prosthesis users (mean age 56; 5 female; 4 male) participated in one-on-one semistructured telephone interviews. Inductive thematic analysis was performed to identify a codebook and emerging themes from the interview transcripts. Results: Two major themes were identified: (1) expectations and prioritization of 3D printed socket usability and (2) facilitators and barriers to uptake of DT among patients. Conclusion: DT methods were found to be acceptable and feasible from a patient perspective, although technological advancements are still required, and real-time communication about the process may be vital for ensuring patient engagement. Consideration of these findings may improve patient satisfaction to emerging prosthesis treatment plans and ultimately support widespread adoption of DT as an additional tool for fabricating prosthetic sockets.

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