‘A whole different ball game’: the qualitative experience of older adults with a transtibial amputation and the use of a self-aligning prosthetic ankle-foot on the STEPFORWARD trial

Mitchell, Natasha; Leggett, Heather; Watson, Judith; McDaid, Catriona T.; Barnett, Cleveland; Twiste, Martin; Vanicek, Natalie

Abstract

Background
Older patients with lower limb amputation, categorised as having “limited community mobility”, are under-researched. Understanding their experience with a new prosthetic ankle-foot is important when designing clinical trials. The aim of this qualitative study was to explore the adjustments they made after amputation and the acceptability of a self-aligning ankle-foot (SA-AF) to older adults.

Methods
Fourteen participants, who took part in the STEPFORWARD randomised controlled feasibility trial (ISRCTN15043643), were purposively recruited; nine were intervention participants and five were standard care participants. They were asked to reflect on their life prior to and consider the adjustments they made following their amputation. Participants in the intervention group were also asked about their views of the new SA-AF compared to their standard non-SA-AF. A thematic analysis was undertaken.

Results
Three broad themes were identified: The impact of the amputation; Role of clinical support; and Experiences of the SA-AF. The findings tell a narrative of the long-term impact that amputation has on these individuals’ lives. Participants randomised to receive the SA-AF were very positive about it, reporting less pain, greater mobility and being able to do more.

Conclusion
Participants who used the SA-AF found it an acceptable intervention. These findings suggest that a full-scale RCT is warranted.

Citation

Mitchell, N., Leggett, H., Watson, J., McDaid, C. T., Barnett, C., Twiste, M., & Vanicek, N. (2024). ‘A whole different ball game’: the qualitative experience of older adults with a transtibial amputation and the use of a self-aligning prosthetic ankle-foot on the STEPFORWARD trial. Disability and Rehabilitation, 46(7), 1422-1431. https://doi.org/10.1080/09638288.2023.2199222

• Journal Article Type: Article
• Acceptance Date: Mar 30, 2023
• Online Publication Date: Apr 23, 2023
• Publication Date: Mar 26, 2024
• Deposit Date: Apr 4, 2023
• Publicly Available Date: Jun 7, 2023
• Journal: Disability and Rehabilitation
• Print ISSN: 0963-8288
• Electronic ISSN: 1464-5165
• Publisher: Taylor and Francis
• Peer Reviewed: Peer Reviewed
• Volume: 46
• Issue: 7
• Pages: 1422-1431
• DOI: https://doi.org/10.1080/09638288.2023.2199222
• Keywords: Rehabilitation
• Additional Information: Projects : Patient acceptability to a novel prosthetic device: A randomised feasibility study in older patients with vascular related amputations and multimorbidities.