The influence of environmental and personal factors on participation of lower-limb prosthetic users in low-income countries: prosthetists' perspectives

Purpose: To examine the environmental and personal factors in low-income countries (LICs) that influence prosthetic rehabilitation of adults with lower-limb (LL) amputations and their ability to participate in daily activities. Methods: In this qualitative descriptive study, 11 prosthetists participated in semi-structured interviews by telephone or Skype. Qualitative thematic analysis was guided by the International Classification of Function. Results: Facilitating continuity of care, consideration of physical environments and usage, prosthetic quality including durability and socket fit, and minimizing the visibility of disability, were found to be important factors affecting the provision of prosthetic services in LICs. Conclusions: Environmental and personal factors must be considered when providing prosthetic rehabilitation for adults with LL amputations in LICs in order to optimize participation in activities. Results from this study provide new insights about some of the factors that influence the ability of individuals with LL amputations to rehabilitate to a level where they are able to participate in meaningful activities within their communities.