Efficacy of rehabilitation after provision of ICRC lower limb prostheses in low-income and middle-income countries : a quantitative assessment from Myanmar

Background: Low-income and middle-income countries (LMICs) have poorly resourced health services. Lack of access to assistive devices, such as prosthetics, may limit the functional outcomes of persons with amputation and affect quality of life (QoL). Objective: The objective of this study was to assess the functional level and QoL of prosthetic users in LMICs when prescribed a prosthesis made from International Committee for Red Cross (ICRC) components. Study design: The study design included a quantitative descriptive methodology assessing functional outcomes and QoL after prosthetic provision. Methods: Participants were identified from the prosthetic service in Mandalay, Myanmar. Included participants were those with unilateral, traumatic, lower limb amputations, with ICRC devices delivered at least 6 months earlier. Participants attended the prosthetic service and were assessed using the Amputee Mobility Predictor with Prosthesis tool and the World Health Organization Quality of Life Brief and Disability modules. Results: Thirty-five participants completed the study; of them, 63% were persons with transtibial level amputation and 37% were with transfemoral level amputation. Approximately 83% achieved a score of more than 37 using the Amputee Mobility Predictor with Prosthesis. There is a strong positive correlation between QoL and physical health (r = 0.55; p < 0.001), social relationships (r = 0.66; p < 0.001), and inclusion (r = 0.53; p < 0.001). Participants had a better QoL and overall health when they had better psychological health. Conclusion: The patient-based results presented within this study could be considered as a contribution to the evidence base and importance of provision of prosthetic services in LMICs. It was observed that participants with an amputation were able to achieve a high level of physical function with the ICRC prostheses while also reporting a high QoL

The Vertical Ground Reaction Force and Temporal-Spatial Parameters of Transfemoral Amputees Wearing Three Prosthetic Knee Joints Available in Thailand: a Pilot Study

Objective: To examine the temporal-spatial characteristics of transfemoral amputees using three prosthetic knees available in Thailand. In addition, the estimated vertical Ground Reaction Force (vGRF) was explored, in particular the graphical differences in the M-shape of the vGRF pattern amongst each of the knees and the sound limb. Methods: Three transfemoral amputees were fitted with three different prosthetic knee joints (Chulalongkorn University (CU) Polycentric Knee Joint, Prosthesis Foundation Knee, Otto Bock 3R20) and performed walking trials while the vGRF and temporal-spatial parameters were collected for all participants. Results: Similarities existed amongst GRF metrics across all prosthetic knees. Stance and swing time in the CU Polycentric Knee Joint was similar to that of the sound limb. Walking speeds were highest in the Otto Bock 3R20 and lowest in the Prosthesis Foundation Knee. Conclusion: This preliminary pilot testing revealed similarities amongst all three prosthetic knees. Future research with more participants and additional analysis could further elucidate characteristics of these prosthetic knees