8.15 Usability and practicality of the prosthesis
on carpet, a wooden verandah, grass or road surface and with a bag of shopping. Likewise, for a person with an upper limb prosthetic, picking up an item in a clinic is different to picking up a special breakable item at home or giving someone a gift. Personal factors and situations can also impact on the person’s use of the prosthesis, for example, fatigue, whether the person underwent multiple amputations (upper and lower, or bilateral) or whether the dominant arm was involved (amputation or brachial plexus injury).
Prosthesis prescription is crucial to the person’s outcomes. Fit and comfort are important, but usability and practicality are also important. Contextual factors influence the person’s use of the prosthesis. Trialling a prosthesis, componentry or walking aids in a clinic will not provide the opportunity to check whether the prosthesis components are fit for purpose in real-life circumstances. Trials also need to occur at home and in the community. It is not only the movement, action or activity that needs to be tested, but also the factors in a person’s environment and real life that may impact their use of the prosthesis. These factors include the natural or built environment, noise, time pressures, weather conditions and light, but also whether people are watching them, and the meaningfulness of the activity for the person. For example, walking around with a lower limb prosthesis in a clinic is different to walking
It is critical that the prosthesis and componentry is the best and most appropriate option for the person, determined after all relevant factors are considered, and that componentry is trialled for a suitable time. Any trials should be in collaboration with other members of the multidisciplinary team (e.g. occupational therapist) and over a reasonable period of time (e.g. two weeks). Trial and use of the prosthesis in different contexts will assist the person’s confidence in its use and practicality, and their commitment and sense of ownership.
Best practice note—12 Trial of prosthesis componentry Best practice prosthetic prescription is when trial of componentry is standard practice. The trial should occur:
• • • • • • • •
over a number of weeks in the real world in collaboration with the multidisciplinary team. The trial and practice should include time: in the home, including undertaking activities of daily living, e.g. self-care and domestic tasks performing activities relevant to the person’s goals at work (if applicable) performing relevant leisure activities.
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It is appropriate to include a trial of the prosthetic device, a report on the outcome and a quote for the final prosthesis in the quote submitted to the funder.
© icareTM | Insurance and Care NSW 2021
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icare Guidance for people with a limb amputation 2021
