595 - Testing the feasibility and acceptability of an immediate-fit, adjustable lower limb prosthetic system in a low-resource country

Objectives: To assess the feasibility and acceptability of an immediate-fit, fully adjustable prosthetic system in Botswana, a low-resource country in southern Africa.

Design: Persons with transtibial and transfemoral lower limb loss who volunteered to test the devices were fit with these prostheses. Fittings took place at an urban academic center and two rural clinics. Individuals were fitted in a single session using only hand and power tools. In addition to instruction on adjusting and using the device, patients received gait training from local physical therapists.

Results: Sixteen persons were successfully fit within the 10-day study period. There were 11 transtibial and 6 transfemoral prostheses fit, with one person with bilateral amputations receiving both a transfemoral and transtibial device. The majority (n=11, 68.8%) were male; average age was 51.4 years (range: 37 to 80 years) old. In 10 subjects, the etiology of limb loss was diabetes (62.5 %), followed by infection (n=3, 18.8%), trauma (n=2, 12.5 %), and one due to vascular disease (6.3%). For the majority (n=12, 75%), the adjustable device was their first prosthesis. Self-reported waiting time for receiving a prosthesis ranged from 4 months up to 9 years, with an average of 2.2 years (median=1.3 years). All of the subjects were able to ambulate with the immediate-fit prosthesis and demonstrated proficiency in using it. A follow-up is planned to assess continued use, reasons for discontinuation if any, and durability of the system.

Conclusions: Long wait times can adversely impact persons with limb loss; having a system that can readily accommodate these individuals can be beneficial to the individual and country’s health system. The immediate fit, adjustable prosthetic system is a viable alternative for reducing disability secondary to limb loss in Botswana. The system was well-received by local prosthetists and holds great promise for alleviating long wait times.