Longitudinal study of prosthesis use in veterans with upper limb amputation

Background: Little is known about the patterns of prosthesis use and satisfaction of those who cease use or begin to use upper limb prostheses. Objectives: Among a longitudinal sample of Veterans with upper limb amputation, (1) describe changes in prosthesis use over 1 year, (2) examine rates of receipt of new prostheses, and (3) compare prosthesis satisfaction in respondents who received a new prosthesis to those who did not. Study Design: Longitudinal survey. Methods: 808 Veterans who had participated in a baseline interview 1 year earlier were invited to participate in structured telephone interviews. Results: A total of 562 persons with unilateral and 23 with bilateral amputation participated in the interviews (Response rate = 72.4% and 85.2%, respectively). Prosthesis use, frequency and intensity of use, and types of prostheses used were stable over 1 year. About 24% reported using a different primary terminal device type at follow-up than baseline. Prosthesis use was less frequent/intense at baseline among those who discontinued use compared with those who did not (P < 0.05), and less frequent/intense for those who started compared with those who continued using a prosthesis (P < 0.0001). Rates of prosthetic training were higher among those who received a different prosthesis type compared with those using the same type (P = 0.06). Satisfaction scores were higher (P < 0.01) for new prosthesis recipients, and lower at baseline for prosthesis abandoners compared with continued users (P = 0.03). Conclusion: Prosthesis abandonment appears to be predicated on dissatisfaction with the device, as well as less frequent/intense prosthesis use. These findings can be used to identify those at risk for prosthesis abandonment and improve their prosthesis experience.