The association between upper limb prosthesis receipt timing and prosthesis adoption and satisfaction: Findings from a cross-sectional study.

Background: Little empirical evidence supports the widely held belief that early upper limb prosthesis fitting is associated with improved longer-term outcomes.

Objectives: To quantify the relationship between timing of initial prosthesis receipt and (1) continued prosthesis use, (2) hours of use, and (3) satisfaction.

Study design: Cross-sectional survey study of 698 Veterans with major upper limb amputation.

Methods: Participant characteristics were described by time to receipt of initial prosthesis. Logistic regressions examined relationships between receipt timing, prosthesis use, and odds of using a prosthesis ≥8 h/d. Linear regression examined the relationship between receipt timing and scores of the Trinity Amputation and Prosthetic Experience Satisfaction Scale satisfaction scale. Models controlled for potential confounders including age, gender, amputation level, race, ethnicity, amputation etiology, time from injury to amputation, years since amputation, and prosthesis type.

Results: Odds of current prosthesis use were lower with prosthesis receipt within 6-12 months (odds ratio: 0.56; 95% confidence interval [CI], 0.34, 0.92) and ≥12 months (odds ratio: 0.55; 95%CI, 0.32, 0.96) compared with within 3-6 months. Trinity Amputation and Prosthetic Experience Satisfaction Scale scores were -0.22 points lower (95%CI, -0.38, -0.06) for receipt within 6-12 months. Receipt timing was not associated with 8+ h/d of prosthesis use.

Conclusions: This nationally representative study of Veterans found initial prosthesis receipt within 3-6 months (compared with 6-12 months) was associated with increased odds of continued prosthesis use. Prosthesis receipt within 6 months was associated with greater prosthesis satisfaction.