Patient-Specific Requirements of Upper Limb Prosthetic Technology
Abstract
Rationale: Upper limb prostheses can improve functional independence, enhance community integration, and improve quality of life. However, the process of matching each patient to the right prosthesis remains challenging, and suboptimal matching can result in device abandonment and poorer clinical outcomes. There are many prosthetic options for people with upper limb amputation (ULA), and navigating these options can be difficult for these persons, their families, and their healthcare providers. It is also not well understood how prosthetic features interact with patient preferences, goals, and other psychological or social factors related to prosthesis use. In order to improve the function and quality of life of Veterans/Warfighters with ULA, we need to more fully understand the patient-specific factors that contribute to prosthesis acceptance and rejection and develop strategies to optimize prosthesis prescription. Objectives of the Study: The primary goal of the proposed study is to understand how the needs, expectations, and health care experiences of Veterans/Warfighters with ULA impact what they think and feel about their prosthesis and how and when they use a prosthesis. We will examine experiences with prosthesis education, selection, and training, as well as how psychological and social issues impact prosthesis use. We will interview people who use prostheses as well as people who have abandoned prostheses to learn about their experiences, opinions, and viewpoints on prosthesis use and their amputation rehabilitation process. We aim to build a conceptual framework explaining user attitudes toward different prosthetic devices and how these are influenced by experiences with rehabilitation care, social interactions, expectations about functional capability, and other important aspects of the prosthesis use experience. The secondary goal of the proposed project is to develop a tool to help clinicians and patients work together to select the prosthesis that will best meet the patient’s needs. We will talk with groups of people with ULA and groups of rehabilitation clinicians through focus groups to create this tool so that it will have maximum impact on clinical practice. Potential Impacts of the Research: Who will be helped – This research will help people with ULA who currently use or are interested in using prostheses. ULA is a significant issue for the health and well-being of both the general population and the military. Approximately 2.2 million people in America are living with the loss of a limb, and about 66,000 of these persons have ULA. As of 2015, there were 1,645 American Service Members with one or more major traumatic limb amputations from recent military operations. Approximately 300 of these Service Members lost an upper limb. There are approximately 3,000 individuals with ULA served by the Department of Veterans Affairs (VA). Clinical applications – Veterans/Warfighters with ULA will share their thoughts and views on currently available prostheses and rehabilitation processes to help rehabilitation researchers and clinicians better understand the complex experience of upper limb prosthesis selection, training, and use. The conceptual framework developed in this study will enable researchers to accelerate future discoveries and technology advancements. This framework, along with our clinical decision tool, will help clinicians recommend prosthetic devices and personalized treatments to improve patient outcomes. Study findings may ultimately influence ULA rehabilitation standard of care. Projected timeline – During the study period, we will construct a conceptual framework that explains prosthesis acceptance and develop a prototype clinical decision tool to aid patient-prosthesis matching. The study findings can be implemented immediately in the clinic through training for clinical personnel, education materials for patients and their families, and clinical practice recommendations for up
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Jan 04, 2024
- Source ID
- HT94252310114
Entities
People
- Emily L Graczyk
Organizations
- Louis Stokes Cleveland VA Medical Center
- United States Army