Consumer concerns and the functional value of prostheses to upper limb amputees.

This paper reports a study of 66 upper limb amputees in County Funen, Denmark who were visited in their homes by the author. The purpose of the study was to evaluate the consumer concerns about their prostheses and to see if these were related to cessation of prosthetic use. It was also intended to estimate functional levels of both prosthetic users and non-users. The number of amputees investigated corresponds to the annual number of persons becoming upper limb amputees in Denmark. There were 3 prosthetic systems in use, two active systems and one passive system. At review there was a group of 18 amputees which did not use a prosthesis at all. It appeared that active and partially active users are younger persons with a relatively short time-lapse since amputation. Passive users are older persons with a long time-lapse since amputation. Only 4 out of 18 prosthetic non-users stopped prosthetic use as a consequence of prosthetic problems or discomfort. Active prostheses had the highest number of consumer problems. Most problems were concerned with the socket, and for the body powered prostheses also with the suspension and control system. It was shown that an awareness of the amputee's working conditions is important at the fitting stage, especially the daily working situation. As a consequence strictly individual fitting is needed with attention being given to the manner in which the individual will use the prosthesis. This investigation clearly shows that active fitting is a worthy effort. In daily living the active users have a superior performance over the passive and non-users. It was observed that amputees despite many years of training still have problems with activities of daily living, particularly in relation to independent functions.