Exploring meaningful outcome domains of recovery following lower limb amputation and prosthetic rehabilitation: the patient’s perspective
Exploring meaningful outcome domains of recovery following lower limb amputation and prosthetic rehabilitation: the patient’s perspective
Purpose: there is currently no consensus regarding what outcome domains to measure following lower limb prosthetic rehabilitation. Prosthetic users have a unique insight into important outcome domains, little is currently known about their critical viewpoint.
Materials and methods: a total of 37 participants who underwent lower limb amputation in the last five years were recruited from UK limb fitting centres and social media. Data were collected using focus groups and interviews and analysed using reflexive thematic analysis.
Results: five themes were identified. 1) The ability to participate in important activities, 2) how participants were able to undertake these activities, i.e., independently, with ease, safely and with minimal equipment. 3) A comfortable, easy-to-use prosthesis, 4) the importance of managing pain and finally, 5) adjusting and accepting their new normal. These five themes, or outcome domains, did not exist in isolation, but appeared to interact with each other, contributing to, or inhibiting the participant’s holistic sense of recovery.
Conclusions: understanding important outcome domains that define what recovery means to people following amputation can help to inform domain consensus, as well as direct the focus of rehabilitation. Domain consensus would guide the selection of measurement tools that evaluate prosthetic interventions in a meaningful way.IMPLICATIONS FOR REHABILITATION There is currently no consensus around which outcome domains should be measured following prosthetic rehabilitation. Outcome domains of importance from a patient’s perspective focus on participation in important activities, prosthesis comfort, pain management, and acceptance of their new normal. Identifying these domains can help direct the focus of rehabilitation as well as inform outcome measurement practice. The interrelated nature of these domains suggests the need for a physical and psychosocial multi-domain approach to outcome measurement in prosthetic rehabilitation, with patient priorities at its centre.
Outcome, amputation, experience, meaningful, measurement, prosthetic, qualitative, recovery
3937–3950
Ostler, Chantel Marie
c5e34ffb-7763-4fc0-98a4-128d1ed5d967
Donovan-Hall, Maggie
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Dickinson, Alex
10151972-c1b5-4f7d-bc12-6482b5870cad
Metcalf, Cheryl
09a47264-8bd5-43bd-a93e-177992c22c72
12 November 2022
Ostler, Chantel Marie
c5e34ffb-7763-4fc0-98a4-128d1ed5d967
Donovan-Hall, Maggie
5f138055-2162-4982-846c-5c92411055e0
Dickinson, Alex
10151972-c1b5-4f7d-bc12-6482b5870cad
Metcalf, Cheryl
09a47264-8bd5-43bd-a93e-177992c22c72
Ostler, Chantel Marie, Donovan-Hall, Maggie, Dickinson, Alex and Metcalf, Cheryl
(2022)
Exploring meaningful outcome domains of recovery following lower limb amputation and prosthetic rehabilitation: the patient’s perspective.
Disability and Rehabilitation, 45 (23), .
(doi:10.1080/09638288.2022.2138989).
Abstract
Purpose: there is currently no consensus regarding what outcome domains to measure following lower limb prosthetic rehabilitation. Prosthetic users have a unique insight into important outcome domains, little is currently known about their critical viewpoint.
Materials and methods: a total of 37 participants who underwent lower limb amputation in the last five years were recruited from UK limb fitting centres and social media. Data were collected using focus groups and interviews and analysed using reflexive thematic analysis.
Results: five themes were identified. 1) The ability to participate in important activities, 2) how participants were able to undertake these activities, i.e., independently, with ease, safely and with minimal equipment. 3) A comfortable, easy-to-use prosthesis, 4) the importance of managing pain and finally, 5) adjusting and accepting their new normal. These five themes, or outcome domains, did not exist in isolation, but appeared to interact with each other, contributing to, or inhibiting the participant’s holistic sense of recovery.
Conclusions: understanding important outcome domains that define what recovery means to people following amputation can help to inform domain consensus, as well as direct the focus of rehabilitation. Domain consensus would guide the selection of measurement tools that evaluate prosthetic interventions in a meaningful way.IMPLICATIONS FOR REHABILITATION There is currently no consensus around which outcome domains should be measured following prosthetic rehabilitation. Outcome domains of importance from a patient’s perspective focus on participation in important activities, prosthesis comfort, pain management, and acceptance of their new normal. Identifying these domains can help direct the focus of rehabilitation as well as inform outcome measurement practice. The interrelated nature of these domains suggests the need for a physical and psychosocial multi-domain approach to outcome measurement in prosthetic rehabilitation, with patient priorities at its centre.
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Exploring meaningful outcome domains of recovery following lower limb amputation and prosthetic rehabilitation the patient s perspective
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Accepted/In Press date: 9 October 2022
e-pub ahead of print date: 11 November 2022
Published date: 12 November 2022
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Funding Information:
The authors thank the public research partners and all participants of the research for sharing their experiences. The authors also acknowledge and thank the project funders the British Association of Chartered Physiotherapist in Limb Absence Rehabilitation (BACPAR), the Institute for Life Sciences at the University of Southampton, the Engineering and Physical Sciences Research Council (EPSRC)/National Institute for Health Research (NIHR) Global Challenges Research Fund [grant EP/R014213/1], and the Royal Academy of Engineering [RAEng grant RF/130].
Keywords:
Outcome, amputation, experience, meaningful, measurement, prosthetic, qualitative, recovery
Identifiers
Local EPrints ID: 472652
URI: http://eprints.soton.ac.uk/id/eprint/472652
ISSN: 0963-8288
PURE UUID: 69c8e319-dd67-43ab-8113-77b79adca866
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Date deposited: 13 Dec 2022 17:40
Last modified: 17 Mar 2024 03:09
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Author:
Chantel Marie Ostler
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