Most Lower Limb Amputees Are Generally Satisfied With Prostheses, Clinical Services—Survey
After amputation surgery, lower-limb amputees suffer from an inefficient gait as the body adjusts and compensates for deviations from the normal gait. Thus, the prosthetic components’ design and fit are essential to reduce the harmful effects of these deviations. However, traditional prosthetic feet have been found inadequate in improving the energy demands of the gait change.
To further improve the design and fit of prosthetic devices and the quality of clinical services, experts deemed it necessary to determine the satisfaction level of people with limb loss. Researchers in Saudi Arabia sought to evaluate the satisfaction level of lower limb amputees with their prosthetic devices and the quality of clinical services they receive. They conducted a cross-sectional survey at the Medical Rehabilitation Hospital in Madinah, Saudi Arabia, from August 2018 to November 2019. Similar satisfaction surveys have already been conducted in Vietnam and the Netherlands.
The survey
A total of 220 participants—composed of 183 males and 37 females—formed the final sample. Of the 220, 43 had above-knee limb loss consisting of 37 males and six females. Meanwhile, 168 had below-knee amputations; this group was composed of 146 males and 22 females. In addition, nine females had partial-foot amputations.
The survey participants were native Arabic speakers aged 18 and up. They have acquired their prosthetic limbs from the Medical Rehabilitation Hospital and have used their devices for at least three months.
To evaluate prosthetic device satisfaction, the researchers asked questions about the comfort, weight, fit, ease of donning, skin irritation, pain, cosmesis, maintenance, durability, wear-and-tear of clothes, and affordability in terms of the repair or replacement of the prosthetic components.
Meanwhile, researchers determined the participants’ satisfaction with clinical services by asking questions about device selection, discussion of issues, participation in decision-making, prosthetic device usage training, waiting times, coordination between the patient’s prosthetic or orthotic facility and their physicians and therapists, and the opportunity to express concerns.
Results
The participants’ responses to questions about their satisfaction with their prosthetic device showed that the number one issue is the affordability of purchasing, maintaining, and repairing or replacing the device. The researchers found this surprising as health care is free of cost to all patients, and the government or health insurance mostly covers payments.
According to the researchers, perhaps the issue with affordability stems from the participants’ fear of losing their coverage if they provide honest feedback on their ability to purchase and maintain their prosthetic limbs.
An average of 30% of the participants expressed dissatisfaction with all other areas of prosthetic device satisfaction, like the comfort, fit, pain, ease of donning, wear-and-tear of clothes when wearing their prostheses, and cosmesis.
The researchers noted that all the points raised are related to the fact that although the devices were made of high-quality imported components, assembly of the prosthetic device is done by hand with limited equipment at the hospital.
When it came to the participants’ satisfaction with clinical services, the collective level was higher.
The areas of minor dissatisfaction were related to the lack of information on equipment choices, lack of opportunity to express concerns over the device, and insufficient discussion with the prosthetist about potential problems with the prosthetic limb.
Overall, most of the participants were generally satisfied with their prosthetic devices (mean score of 46.0), and most of them were satisfied with the clinical services (mean score of 74.1).
In comparison, three studies from Vietnam found that only 10% of amputees were not satisfied with their prosthetic limbs. And two studies from the Netherlands reported that 75% and 85% of participants were happy with their prosthetic limbs and clinical services, respectively. However, the researchers noted limitations with these studies, like differences in the questions and the types of prosthetic devices.
What about you? How would you rate your satisfaction with your prosthetic limb and the quality of clinical services you receive?
