학술논문
Prosthesis usability experience is associated with extent of upper limb prosthesis adoption: A Structural Equation Modeling (SEM) analysis.
Document Type
Academic Journal
Author
Resnik LJ; Providence VA Medical Center, Providence, Rhode Island, United States of America.; Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, Rhode Island, United States of America.; Borgia M; Providence VA Medical Center, Providence, Rhode Island, United States of America.; Graczyk EL; Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, United States of America.; Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, Ohio, United States of America.; Barth J; Providence VA Medical Center, Providence, Rhode Island, United States of America.; Center for Innovation in Long-Term Services & Supports, Providence VA Medical Center, Providence, Rhode Island, United States of America.; Ni P; Biostatistics & Epidemiology Data Analytic Center, Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, Massachusetts, United States of America.
Source
Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE
Subject
Language
English
Abstract
Factors associated with upper limb prosthesis adoption are not well understood. In this study, we explored how prosthesis usability experience relates to the extent of prosthesis adoption through the development of a structural equation model (SEM). First, items related to prosthesis usability were developed and refined using cognitive testing and pilot testing and employed in a survey of 402 prosthesis users (mean age 61.7 (sd 14.4), 77.1% Veterans). The SEM examined two unidimensional latent constructs: Prosthesis Usability Experience and Prosthesis Adoption-and each had multiple measured indicators. SEMs tested direct as well as moderating and mediating effects between the latent constructs and covariates related to demographics and prosthesis type. SEM found a significant positive association between Prosthesis Usability Experience and Extent of Prosthesis Adoption. Several covariates had direct effects on prosthesis adoption: 1) Extent of Prosthesis Adoption was lower for those with transhumeral and shoulder amputation, and higher for those with bilateral amputation, compared to the reference group with unilateral transradial amputation and 2) Myoelectric multiple degree of freedom (multi-DOF) prosthesis use was associated with lower Extent of Prosthesis Adoption, compared to body-powered prosthesis use. Myoelectric multi-DOF use also modified the effect of Prosthesis Usability Experience on Extent of Prosthesis Adoption. For those with bilateral ULA, the strength of the relationship between Prosthesis Usability Experience and Extent of Prosthesis Adoption was reduced. Findings suggest that in order to increase prosthesis adoption, prosthetics developers and rehabilitation providers should focus on implementing strategies to improve prosthesis usability experience. New Prosthesis Usability Experience measures could be used to identify persons at greater risk for poor prosthesis adoption and target interventions to increase prosthesis use.
Competing Interests: The authors have declared that no competing interests exist. Opinions, interpretations, conclusions and recommendations are those of the author and not necessarily endorsed by the Department of Defense.
(Copyright: This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.)
Competing Interests: The authors have declared that no competing interests exist. Opinions, interpretations, conclusions and recommendations are those of the author and not necessarily endorsed by the Department of Defense.
(Copyright: This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.)