Developing consensus on important factors associated with lower limb prosthetic prescription and use

Purpose: There is an ongoing concern in lower limb prosthetic rehabilitation with underuse and nonuse of prosthetic technology. The aim of this study was to gather expert opinion on the most important outcomes, predictors and facilitators of lower limb prosthetic prescription and use, with a long-term goal of improving satisfaction with prosthetic technology. Method: An electronic Delphi study was conducted using an expert panel of 21 service providers and users and was undertaken over three iterations. Results: The process resulted in the identification of 13 outcomes, 19 predictor and 34 facilitator factors. Conclusions: Psychosocial factors related to service provision and prosthetic use have not been widely recognized or incorporated into clinical practice. We highlight the need for creating standardized measures that incorporate psychosocial factors and that can contribute to a broadly applicable evidence base for optimal prosthetic prescription.