Activity and Participation, Bimanual Function, and Prosthesis Satisfaction are Strong Predictors of General Well-Being Among Upper Limb Prosthesis Users.
Phillip M Stevens, Dwiesha L England, Amy E Todd and 2 others
PMID 37312977WHAT IT FOUND
For upper limb prosthesis users, feeling able to take part in social roles, doing two-handed tasks, being satisfied with the prosthesis, and having less pain interference were linked to better well-being.
Daily wear time was not linked to well-being.
Key findings
01Among 250 upper limb prosthesis users, the multivariate model for well-being was statistically significant, and four predictors were statistically significant: activity and participation, bimanual physical function, pain interference, and prosthesis satisfaction.
02Activity and participation was the largest predictor of greater well-being, and higher activity and participation, higher bimanual physical function, and higher prosthesis satisfaction were associated with greater well-being, while higher pain interference was associated with lower well-being.
03Age, gender, amputation level, time since amputation, and daily prosthesis wear time were not statistically significant predictors of well-being in the multivariate model.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
This was a retrospective cross-sectional analysis, so it cannot show that changes in activity, bimanual function, satisfaction, or pain caused changes in well-being. The sample only included people who had a prosthesis and returned for follow-up care, so it likely misses people who rejected or stopped using a prosthesis and people who never had one. For patients with more than one follow-up visit, the visit with the highest well-being score was chosen, which may present a best-state picture rather than typical experience. Missing values were filled with the mean after a test suggested missing at random, which can weaken the reliability of the estimates. Some patients were seen during appointments seeking adjustments, so the outcomes may not reflect a stable best state. Amputation cause and timing from first appointment to follow-up were not fully captured, and factors may differ for congenital versus acquired amputation.
The easy way to misread this
Do not read this as proof that improving activity, bimanual function, prosthesis satisfaction, or pain will raise well-being. The study was cross-sectional and only showed associations at follow-up visits, and it did not include people who had stopped using a prosthesis.