User-Reported Comfort, Functionality, and Satisfaction Among Pediatric Lower Limb Amputees Using Conventional Prosthetic Devices: A Multi-Center Cross-Sectional Study.

Background/

Objectives

To determine user-reported comfort, function, and overall satisfaction among pediatric lower limb amputees with conventional prosthetic devices and to identify possible factors associated with overall satisfaction.

Methods

A cross-sectional observational study was conducted at three tertiary orthotic and prosthetic centers in the Eastern Cape, South Africa. Caregiver-child dyads completed a structured questionnaire evaluating perceived prosthetic comfort, functionality, and satisfaction. There were fifty-two unilateral pediatric lower limb amputees aged 4-17 years who had used conventional prosthetic appliances for at least one year. Questionnaire responses were summarized using descriptive statistics. Spearman's rank correlation and non-parametric tests were used to examine associations among study variables. Multiple linear regression analysis was performed to identify factors independently associated with overall satisfaction.

Results

Mean comfort was 3.54 (SD = 0.87), functionality satisfaction was 3.42 (SD = 0.78), and overall satisfaction was 2.73 (SD = 0.79). Comfort had strong correlations with functionality (ρ = 0.63, p < 0.001) and overall satisfaction (ρ = 0.69, p < 0.001). The satisfaction difference between congenital and acquired amputations was statistically significant (p = 0.006), with those with congenital amputation reporting substantially greater satisfaction than those with acquired amputation. Multiple linear regression analysis showed that perceived prosthetic functionality (β = 0.383, p < 0.001) and comfort (β = -0.535, p < 0.001) were independently associated with overall satisfaction.

Conclusions

Perceived comfort and prosthetic functionality were independently associated with overall satisfaction among pediatric users of conventional prosthetic devices. These findings support patient-centered prosthetic design and rehabilitation strategies that prioritize socket comfort and functional performance to improve children's overall satisfaction with their prosthetic devices.