User experiences of a myoelectric hand prosthesis: A qualitative study

Posada, Ana-María; Maya, María-Alejandra

Universidad de Antioquia - Prótesis Avanzadas S.A.S. - Hospital San Vicente Fundación

Introduction/Background

The rates of upper limb prosthesis use vary between 37% and 83%. Contextual and personal factors play an important role in the acceptance
process of the prosthesis. There is limited qualitative research on individuals with upper limb amputations, which is essential to enhance
rehabilitation and assist multidisciplinary teams in developing strategies to increase prosthesis use, improve mobility and physical activity, and
optimize health outcomes for this population. Objective: To obtain a comprehensive understanding of the experience of living with upper limb
amputation and the perceptions of users of a myoelectric hand prosthesis regarding their quality of life. Study design: Qualitative and
descriptive

Materials and Methods

Study design: a descriptive qualitative methodology was used to understand in detail the phenomenon studied by describing it in everyday
terms. Participants and recruitment: patients with unilateral transradial amputation of any cause, from the outpatient clinic of physiatry,
plastic surgery and orthopedics of the San Vicente Foundation Hospital were included. Intervention: the prosthesis was adapted to each patient
and they were trained in its use during two sessions of 3 hours each. The patients used the prosthesis for two weeks and subsequently a semi-
structured interview was conducted that included open questions about the amputation process, the use of the prosthesis in daily life, their own
perceptions and those of those close to them about the prosthesis. Analysis: Using qualitative content analysis with an inductive approach,
themes covering all aspects of the participants' experience were identified and labeled.

Results

Nine people participated in this study, their demographic and clinical

characteristics were collected: 88.8% of the sample corresponded to men and
11.1% to women, the age of the participants was between 23 and 69 years, time
since amputation in months ranging from 14 to At 540 months, the laterality of
the dominant hand and the amputated hand were recorded. Participants'
experiences were organized into five general themes or components: physical,
activities and participation, mental, social, and factors related to the prosthesis.
These themes and associated subthemes describe how patients use their
prosthesis and the various factors perceived as barriers or facilitators to the use
of prosthesis in everyday life.

Discussion and Conclusion

Discussion: This study demonstrates that upper limb amputee participants seek to regain both physical form and function to minimize the
difference between their current selves and their former selves. The technology in question presents potential benefits but also drawbacks that
restrict its functionality. In this sense, this work explores the daily experiences of the participants to understand not only what activities are
affected by the amputation but also the challenges that this implies to direct new technical capacities in prosthetic design.
The use of the prosthesis seemed to be a continuous evaluation of the balance between the limitations and benefits of the role it fulfilled.
Despite this, the participants showed a positive and accepting attitude, demonstrating a commitment to life and a willingness to adopt new
experiences within their rehabilitation. As a result, their lives appeared to be minimally restricted, and all described fulfilling personally
significant roles.
The use of prostheses can generate a feeling of independence to carry out activities that were not possible before, which is known as prosthetic
performance. Participants expressed dissatisfaction with the socket fit, alignment, and weight of the prosthesis, which caused them pain and
discomfort and negatively affected their overall wear time and functionality. Therefore, optimization of the Aktio hand prosthesis should focus
on improving user comfort to ensure greater use and optimal functionality
.
Conclusions: These findings provide valuable information about the daily experiences of people with upper limb amputations and can help us
implement strategies to optimize the use of the prosthesis.

Participating institutions