Prosthetic device and service satisfaction, quality of life, and functional performance in lower limb prosthesis clients

Abstract

Objective: The aim of this study was to characterize the relationship between prosthetic device and service satisfaction, health-related quality of life (HRQOL), and functional movement in a diverse population of lower limb prosthesis users. Methods: An online survey was conducted on individuals with lower limb amputation between September and October 2021. Sample validated questionnaires assessing demographic and clinical features, satisfaction, functional outcomes, and quality of life were analyzed using path analysis. Results: Participants were 1736 individuals with lower limb amputation. Overall, 44% of participants reported dissatisfaction with prosthetic device, whereas 37% were dissatisfied with prosthetic service. Low functional mobility was reported by 58% of participants and 61% reported low HRQOL. Lower extremity functional status (β = 0.55), HRQOL (β = 0.08), Activities-specific Balance Scale (β = 0.22), and modified fall efficacy scale (β = −0.07) are significantly associated with prosthetic device satisfaction (P < 0.0005, R2 = 0.47). Satisfaction with provider service was significantly associated with lower extremity functional status (β = 0.44) and balance confidence (β = 0.18) (P < 0.0005, R2 = 0.34). Conclusion and Clinical Relevance: Civilians, veterans, and service members reported low functional mobility, low quality of life, and moderate levels of dissatisfaction with their lower extremity prosthetic device and provider service. Improvements in mobility, balance, quality of life, and fall efficacy may enhance device satisfaction. Functional mobility and balance improvements may increase ratings of provider service. This study provides feedback that may improve clinical decisions on lower limb prosthesis patient care.