Prosthesis satisfaction in a national sample of Veterans with upper limb amputation

Background: Many persons with upper limb amputation reject prostheses, and many are not satisfied with their devices. Research is needed to understand modifiable factors related to device satisfaction. Myoelectric devices with multiple degrees of freedom are now available; however, no studies have examined whether they lead to greater device satisfaction. Prosthetic training contributes to more skillful prosthesis use and greater likelihood of long-term use; however, the relationship between training and device satisfaction is unclear. Objectives: (1) To describe and compare satisfaction by prosthesis and terminal device type and (2) to identify factors associated with satisfaction. Study design: Cross-sectional survey. Methods: Participants were 449 persons with unilateral upper limb amputation who used a prosthesis. Participants described their prostheses, prosthetic training, device repairs, visits to a prosthetist, and rated device satisfaction using two standardized measures (Trinity Amputation and Prosthetic Experience Satisfaction Scale and OPUS Client Satisfaction with Devices scale). Multivariate generalized linear regression models examined the relationship between prosthesis and terminal device type and satisfaction, controlling for covariates that were meaningful in bivariate analyses. Results: There were no differences in satisfaction by prosthesis type or terminal device degrees of freedom. Satisfaction was associated with receipt of training to use the initial prosthesis, amputation level, age, and race. Conclusion: No differences in satisfaction by device or terminal device type were observed. Worse satisfaction was associated with more proximal amputation level, younger age, and black race. The association between receipt of initial prosthetic training and device satisfaction points to the critical role of occupational or physical therapy in the early stages of prosthetic care.