Research into the Satisfaction and Use Statistics of Upper Limb Prostheses

The satisfaction and use statistics for upper limb prostheses have been the subject of extensive research, revealing a complex interplay between user needs, device functionality, and psychological factors.

This summary (intended from the perspective of a lay person) tries to draw together findings from various studies to provide an overview regarding user satisfaction and the effectiveness of upper limb prosthetic devices.

User Satisfaction with Upper Limb Prostheses

User satisfaction with upper limb prostheses is influenced by multiple factors, including the type of prosthesis, the level of amputation, and the psychological adjustment of the user.

A study by Berke et al. highlights that despite advancements in technology, such as myoelectric prostheses, satisfaction levels among US Veterans with traumatic limb loss has not significantly improved compared to earlier generations of prostheses. Approximately 30% to 50% of users report minimal daily use of their devices, indicating a gap between technological capability and user satisfaction (Berke et al., 2010).

This finding is echoed by Resnik et al., who found that satisfaction varies significantly based on the level of amputation, with prosthetic users at an amputation level closer to the shoulder reporting lower satisfaction levels (Resnik et al., 2020).

The aesthetic and functional aspects of prostheses also play a crucial role in user satisfaction. Arazpour et al. demonstrated that the aesthetic quality, including colour matching and fitting, significantly impacts user satisfaction (Arazpour et al., 2015). Similarly Atallah et al. noted that the choice of materials in cosmetic silicone prostheses can enhance comfort and appearance, thereby improving user satisfaction (Atallah et al., 2023).

Impact of Design and Technology

Recent advancements in 3D printing technology have opened new avenues for creating customised prostheses.

The participatory design approach is an interesting development. Sims et al. highlights the importance of involving users in the design process to ensure that prosthetic devices meet their functional and aesthetic needs (Sims et al., 2017).

We have all seen the funky results created by paediatric users, who often express dissatisfaction with conventional prostheses due to issues such as comfort and functionality (Sims et al., 2019). By incorporating user feedback into the design process, manufacturers can create prostheses that are more likely to be accepted and used by users (particularly children).

Usage Statistics and Factors Influencing Use

Usage statistics do, however, reveal that a significant proportion of upper limb prosthesis users do not wear their devices regularly.

Research indicates that non-use rates can be as high as 50%, particularly among children (Sims et al., 2019).

Factors contributing to this high rate of non-use include discomfort, lack of functionality, and aesthetic concerns (Jabban et al., 2022).

McFarland et al. found that users with more proximal limb loss were more likely to opt for mechanical or body-powered prostheses, which may be perceived as more functional despite being less technologically advanced (McFarland et al., 2010).

The relationship between prosthesis usage and user satisfaction is complex. Jang et al. reported that a substantial percentage of unilateral upper limb amputees wear their prostheses for only a limited number of hours each day, suggesting that satisfaction with the device is closely linked to its perceived utility in daily activities (Jang et al., 2011).

Psychological Factors and Quality of Life

Psychological factors play a significant role in the satisfaction and usage of upper limb prostheses. Users often experience a range of emotions related to their limb loss and the use of prosthetic devices.

Studies have shown that positive coping strategies and social support can enhance satisfaction levels among users (Reiber et al., 2010).

The perception of ability and quality of life is often influenced by the effectiveness of the prosthesis in facilitating daily activities (McDonald et al., 2018). Users who feel that their prostheses do not adequately restore function may experience frustration and dissatisfaction, leading to abandonment of the device.

Conclusion

In summary, the research into satisfaction and usage statistics of upper limb prostheses reveals a complex picture influenced by technological advancements, design considerations, psychological factors and user involvement.

While significant strides have been made in prosthetic technology, user satisfaction remains a critical challenge, with many individuals reporting dissatisfaction due to issues related to comfort, functionality, and aesthetics. Future research should focus on comprehensive assessments of user satisfaction, particularly in the context of emerging technologies such as 3D printing, and the integration of user feedback into the design process.

From an insurer perspective accessing trial devices and data on the actual amount that they are used is vital given the overall lifetime cost.

References

Arazpour, M., Mardani, M., Bahramizadeh, M., Layeghi, F., Zarezadeh, F., & Curran, S. (2015). The effect of new method of suspension on quality of life, satisfaction, and suspension in patients with finger prostheses. Prosthetics and Orthotics International, 39(3), 197-203. https://doi.org/10.1177/0309364614521653

Atallah, H., Qureshi, A., & Msechu, Z. (2023). Satisfaction of individuals with partial-hand amputations after they were fitted with cosmetic silicone prostheses. Prosthetics and Orthotics International, 47(3), 288-292. https://doi.org/10.1097/pxr.0000000000000196

Berke, G., Fergason, J., Milani, J., Hattingh, J., McDowell, M., Nguyen, V., … & Reiber, G. (2010). Comparison of satisfaction with current prosthetic care in veterans and servicemembers from vietnam and oif/oef conflicts with major traumatic limb loss. The Journal of Rehabilitation Research and Development, 47(4), 361. https://doi.org/10.1682/jrrd.2009.12.0193

Cordella, F., Ciancio, A., Sacchetti, R., Davalli, A., Cutti, A., Guglielmelli, E., … & Zollo, L. (2016). Literature review on needs of upper limb prosthesis users. Frontiers in Neuroscience, 10. https://doi.org/10.3389/fnins.2016.00209

Jabban, L., Metcalfe, B., Raines, J., Zhang, D., & Ainsworth, B. (2022). Experience of adults with upper-limb difference and their views on sensory feedback for prostheses: a mixed methods study.. https://doi.org/10.1101/2022.03.13.22272179

Jang, C., Yang, H., Yang, H., Lee, S., Kwon, J., Yun, B., … & Jeong, H. (2011). A survey on activities of daily living and occupations of upper extremity amputees. Annals of Rehabilitation Medicine, 35(6), 907. https://doi.org/10.5535/arm.2011.35.6.907

McDonald, C., Bennett, C., Rosner, D., & Steele, K. (2018). I am the boy with one hand who can do anything”: perceptions of ability among people with upper limb absence. Canadian Prosthetics & Orthotics Journal. https://doi.org/10.33137/cpoj.v1i2.32001

McFarland, L., Winkler, S., Heinemann, A., Jones, M., & Esquenazi, A. (2010). Unilateral upper-limb loss: satisfaction and prosthetic-device use in veterans and servicemembers from vietnam and oif/oef conflicts. The Journal of Rehabilitation Research and Development, 47(4), 299. https://doi.org/10.1682/jrrd.2009.03.0027

Reiber, G., McFarland, L., Hubbard, S., Maynard, C., Blough, D., Gambel, J., … & Smith, D. (2010). Servicemembers and veterans with major traumatic limb loss from vietnam war and oif/oef conflicts: survey methods, participants, and summary findings. The Journal of Rehabilitation Research and Development, 47(4), 275. https://doi.org/10.1682/jrrd.2010.01.0009

Resnik, L., Borgia, M., Heinemann, A., & Clark, M. (2020). Prosthesis satisfaction in a national sample of veterans with upper limb amputation. Prosthetics and Orthotics International, 44(2), 81-91. https://doi.org/10.1177/0309364619895201

Resnik, L., Ekerholm, S., Borgia, M., & Clark, M. (2019). A national study of veterans with major upper limb amputation: survey methods, participants, and summary findings. Plos One, 14(3), e0213578. https://doi.org/10.1371/journal.pone.0213578

Sims, T., Cranny, A., Metcalf, C., Chappell, P., & Donovan‐Hall, M. (2017). Participatory design of pediatric upper limb prostheses: qualitative methods and prototyping. International Journal of Technology Assessment in Health Care, 33(6), 629-637. https://doi.org/10.1017/s0266462317000836

Sims, T., Donovan‐Hall, M., & Metcalf, C. (2019). Children’s and adolescents’ views on upper limb prostheses in relation to their daily occupations. British Journal of Occupational Therapy, 83(4), 237-245. https://doi.org/10.1177/0308022619865179

Zú?iga, J., Young, K., Peck, J., Srivastava, R., Pierce, J., Dudley, D., … & Bergmann, J. (2019). Remote fitting procedures for upper limb 3d printed prostheses. Expert Review of Medical Devices, 16(3), 257-266. https://doi.org/10.1080/17434440.2019.1572506