Examining the needs of affordable upper limb prosthetic users in India: A questionnaire-based survey

Abstract

BACKGROUND: In 2013 alone, ∼5000 new cases of Upper limb (UL) loss in India were reported. This segment has been poorly understood, with limited or no access to quality prosthetic rehabilitative care. Furthermore, very few studies have been carried out to capture their needs and concerns. OBJECTIVE: To understand demographics and needs of UL prosthesis users belonging to low-and middle-income settings in India. Additionally, this study focuses at gaining insights on patient satisfaction levels, patterns of wear, challenges faced, patient priorities, and affordability. METHODS: The questionnaire-based survey data (n = 60) were acquired through telephone for 53 patients and direct interview for 7 patients and the replies were subjected to statistical analysis. RESULTS: The study reveals that currently available prosthetic arms are not enabling the users to achieve desired functional and satisfaction levels. For a prosthetic UL to be affordable in this context, a price less than Indian Rupee (INR) 20,000 with an instalment mode of payment is preferred. CONCLUSIONS: Major design priorities of the patients are functionality, comfort, and durability. Further, providing a subsidy, minimising delays in limb provision and fitting could maximise long-term prosthetic use and enable a much greater rate of acceptance.

User-relevant factors determining prosthesis choice in persons with major unilateral upper limb defects: A meta-synthesis of qualitative literature and focus group results

“…Table). Seven of the included studies had a mixed methods design [9,12,19,23,[40][41][42]; seven included participants of whom more than 25% did not fit the target population but in which the relevant population was analyzed separately [9,13,20,21,[42][43][44]; and one contained data of using a prosthesis in both home and laboratory environment [45]. Of these studies, only the relevant parts were included.…”

“…Of these studies, only the relevant parts were included. In three studies insufficient information was available to check if the included participants completely met the inclusion criteria [9,21,40]. However, since this was very likely the case, these were included.…”

“…Four studies only included men [19,23,42,47], and two only women [11,20]. In eight studies participants who did not fit the target population were included and not separately analyzed: three studies included participants younger than 18 years [12,40,44]; five studies included participants with bilateral upper limb loss [22,24,42,43,45]; two studies included participants with upper limb loss distal from the wrist [22,43]. In all of these studies, this involved less than 25% of the included participants.…”

“…CASP criteria are presented if they were unmet, which was the case when a question was answered with 'no'. Two of the included studies did not have any unmet CASP criteria [22,44], seven studies had one unmet criterion [9,[41][42][43][47][48][49], one study had two unmet criteria [13] and seven studies had three or more unmet criteria [11,12,21,23,24,40,45]. Two studies could not be assessed with the CASP, since one was a case report and the other a commentary [19,20].…”

Mechanical Testing Methods for Body-Powered Upper-Limb Prostheses: A Case Study

“…A relatively small difference in weight was recorded as a result of the cyclic load and wear on the contacting parts, the average percentage of variation of weight was 0.05%. The 24000 cycles represent a period of 27 days of use of the prosthetic hand, considering that an average person performs 3680 grasp movements per day [22] and that a prosthetic hand user employs it 4 hours per day [23]. Based on the obtained results, the expected annual weight loss of the D1M hand would be 0.67%, which is a low value when compared to the wear rate for common materials.…”