The impact of prosthetic limbs on children with bilateral lower limb amputations using the lived experiences of two adult prosthetic users and healthcare practitioners

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dc.contributor.advisorJoseph, Conranen_ZA
dc.contributor.advisorEnnion, Liezelen_ZA
dc.contributor.authorZantsi, Siphosethuen_ZA
dc.contributor.otherStellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Health and Rehabilitation Sciences. Physiotherapy.en_ZA
dc.date.accessioned2023-03-02T12:58:10Z
dc.date.accessioned2023-05-18T07:09:26Z
dc.date.available2023-03-02T12:58:10Z
dc.date.available2023-05-18T07:09:26Z
dc.date.issued2023-03
dc.descriptionThesis (MScPhysio)--Stellenbosch University, 2023.en_ZA
dc.description.abstractENGLISH SUMMARY: Background: Major lower limb amputations can have a life-changing impact on an individual’s functional mobility. The literature supports the view that children with lower limb amputations, even bilateral amputations, have the potential to be highly functional with a prosthesis. However, there is insufficient research to demonstrate the impact of prostheses on children with bilateral lower limb amputations. This challenges the screening and prescription requirements currently in use which tends to hinder the equitable distribution of prosthetics among people with bilateral lower limb amputations. Aim: The aim of this study was to explore and describe the constructs that determine the impact of prosthetic interventions on children with bilateral lower limb amputations. Method: A multiple-methods approach was adopted for this study which consisted of a secondary scoping review and a primary qualitative study. The scoping review used Arksey & O’Malley’s (2005) five steps to explore and described the constructs used to evaluate the prosthetic impact in children with lower limb amputations in current literature. The information obtained from this review was then used to design the qualitative study. A qualitative approach and descriptive design were also taken for this study. Semi-structured interviews were conducted with two groups of key informants. Group A (five participants) consists of physiotherapists and prosthetists who have experience rehabilitating children with bilateral lower limb amputations. Group B (two participants) include adult prosthetic users who have undergone bilateral lower limb amputations in childhood. In total, seven individuals participated in the study. The interviews were conducted virtually and were recorded, transcribed and analysed using deductive analysis. Results: The findings from the scoping review showed that the constructs and outcome measures used to evaluate the prosthetic impact in children with lower limb amputations had a high focus on physical function as an outcome and were limited in evaluating other constructs of impact in prosthetic intervention, with little focus on the qualitative experiences of prosthetic users, specifically relating to satisfaction, quality of life, and other socio-relational constructs. There was also a low number of children with bilateral amputations included in the studies. The qualitative study exploring the experiences of children who are prosthetic users identified the constructs that impact children with bilateral prosthetic limbs; these include mobility, activities of daily living, physical participation, education, body image, quality of life and socio-economic participation. Challenges that impact prosthetic use are also explored and include personal and environmental challenges such as finances, prosthetic equipment, availability of resources and supportive relationships, as well as pain. Conclusion: While physical function has been a consistently evaluated theme in prosthetic rehabilitation, this study provides other areas of impact that healthcare providers might not assess or consider in their decision-making on prosthetic prescription. The emerging themes are holistic and encourage the use of the International Classification of Functioning, Disability and Health (ICF) model which could be helpful in developing a holistic outcome measure that is appropriate for children with bilateral lower limb amputations. It is hoped that this can provide evidence to improve the distribution of necessary resources to optimise equality among the vulnerable children with bilateral amputations.en_ZA
dc.description.abstractAFRIKAANSE OPSOMMING: Agtergrond: Belangrike onderste ledemaat-amputasies kan 'n lewensveranderende impak op 'n individu se funksionele mobiliteit he. Literatuur staaf die siening dat kinders met onderste ledemaat-amputasies, selfs bilaterale amputasies, die potensiaal het om hoogs funksioneel te wees met 'n prostese. Daar is egter onvoldoende navorsing beskikbaar oor die impak van kinders met prostese met bilaterale onderste ledemaat-amputasies. Dit skep ‘n uitdaging vir die siftings- en voorskrifvereistes wat tans gebruik word, wat geneig is om die billikle verspreiding van prostetika onder mense met bilaterale onderste ledemaat-amputasies te verhinder. Doel: Die doel van hierdie studie is om ondersoek in te stel na die konstrukte wat die impak bepaal van prostetiese ingrepe op kinders met bilaterale onderste ledemaat-amputasies. Metode: Hierdie studie het gebruik gemaak van ‘n gemengde metode benadering wat bestaan uit ‘n omvangsoorsig en ‘n kwalitatiewe studie. In die omvangsoorsig is gebruik gemaak van Arksey en O’Malley (2005) se vyf stappe om die konstrukte te verken en beskryf wat gebruik word om die prostetiese impak by kinders met onderste ledemaat-amputasies te evalueer in hedendaagse literatuur. Die inligting wat uit hierdie oorsig verkry is, is gebruik om die kwalitatiewe studie te skep. 'n Kwalitatiewe benadering en beskrywende ontwerp is ook vir hierdie studie onderneem. Semi-gestruktureerde onderhoude is met twee groepe sleutelinformante gevoer: Groep A (vyf deelnemers) bestaan uit fisioterapeute en prostetikusse wat ondervinding het met die rehabilitasie van kinders met bilaterale onderste ledemaat-amputasies. Groep B (twee deelnemers) sluit in volwasse gebruikers van prostese wat bilaterale onderste ledemaat-amputasies in hulle kinderjare ondergaan het. In totaal het sewe individue aan die studie deelgeneem. Die onderhoude is virtueel gevoer en is opgeneem, getranskribeer en ontleed met behulp van tematiese deduktiewe analise. Resultate: Die bevindinge van die omvangoorsig het getoon dat die konstrukte en uitkomsmaatstawwe wat gebruik is om die prostetiese impak by kinders met onderste ledemaatamputasies te evalueer, 'n groter fokus op die fisiese funksie as 'n uitkoms gehad het en beperk was in die evaluering van ander impakkonstrukte in prostetiese ingrepe. Daar is min fokus geplaas op die kwalitatiewe ervarings van gebruikers met prostese. Die studie het ook min kinders met bilaterale amputasies ingesluit. Die kwalitatiewe studie wat die ervarings van kinders met prostese ondersoek het, het die konstrukte geidentifiseer wat kinders met bilaterale prostetiese ledemate beinvloed. Dit sluit in mobiliteit, daaglikse aktiwiteite, fisiese deelname, opvoeding, liggaamsbeeld, lewenskwaliteit en sosio-ekonomiese deelname. Die uitdagings wat 'n impak op prostetiese gebruik het, word ook ondersoek. Dit sluit uitdagings in soos finansies, prostetiese toerusting, die beskikbaarheid van hulpbronne, ondersteunende verhoudings, asook pyn. Gevolgtrekking: Alhoewel fisiese funksie ‘n konsekwente geevalueerde tema in prostetiese rehabilitasie is, bied hierdie studie ander areas van impak wat verskaffers van gesondheidsorg dalk nie assesseer of oorweeg in hul besluitneming oor die voorskrif van prostese nie. Die temas wat ter voorskyn kom is holisties en moedig die gebruik van die internasionale klassifikasie van funksionering, gestremdheid en gesondheid (FGG) aan wat bruikbaar kan wees in die ontwikkeling van 'n holistiese uitkomsmaatstaf wat geskik is vir kinders met bilaterale onderste ledemaat-amputasies. Dit skep hoop dat dit bewyse kan lewer om die verspreiding van die nodige hulpbronne te verbeter.af_ZA
dc.description.versionMasters
dc.format.extentxiii, 103 pages ; includes annexures
dc.identifier.urihttp://hdl.handle.net/10019.1/127200
dc.language.isoen_ZAen_ZA
dc.publisherStellenbosch : Stellenbosch University
dc.rights.holderStellenbosch University
dc.subject.lcshExtremities (Anatomy) -- Abnormalitiesen_ZA
dc.subject.lcshChildren with disabilities -- Rehabilitationen_ZA
dc.subject.lcshAmputees -- Rehabilitationen_ZA
dc.subject.nameUCTD
dc.titleThe impact of prosthetic limbs on children with bilateral lower limb amputations using the lived experiences of two adult prosthetic users and healthcare practitionersen_ZA
dc.typeThesisen_ZA
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