The Introduction of an Adjustable Upper Limb Prosthetic Socket System into a Ugandan Clinical Service

Pickard, Nicolaas; Mulindwa, Benedict; Ssekitoleko, Robert; Kenney, Laurence; Gracey-McMinn, Lauren; Granat, Malcom; Chadwell, Alix

Abstract

Introduction and Objectives
Previous studies found that people with upper-limb absence (ULA) in Uganda experience poor access to prosthetic services, and often have to manage without a prosthesis. Our previous qualitative work found that social interactions, independence, and employment were all negatively affected by living with poorly-, or un-, addressed ULA.
Prosthetic services in Uganda are restricted by the time and resources needed to produce conventional prosthetic sockets, which relies on skilled staff, working machinery, and access to a range of materials. An adjustable, off-the-shelf socket system, the KOALAA ALX, may offer an alternative which could be easier to deploy in resource-constrained settings. This study assesses the feasibility of introducing the Koalaa into the Fort Portal orthopaedic workshop and captures the impact on participants’ patterns of prosthesis use and real-world behaviours.
Materials and Methods
Eight trans-radial participants were fitted with the Koalaa ALX and supplied with a cosmetic hand and two functional end-effectors. An Axivity (AX3) monitor fitted to the prosthetic wrist recorded wear periods, and an Activpal 4+ recorded their physical activity. Data were collected over ~7 days over: a) baseline period prior to receiving the KOALAA, b) 7-14 days post KOALAA fitting and c) 6 months later. Participants were offered a ‘limb buddy’ support service.
Results
Data collection is complete, and analysis is ongoing. Initial results show most participants continued to use their Koalaa at 6 months. Relationships between periods of prosthetic usage and physical activity have been observed. In some cases, participants were observed to don their prosthesis before leaving the house, in line with the previous qualitative findings.
Conclusions
This novel methodology captures the relationship between prosthetic usage and physical activity allowing insight into the impact of upper limb prosthesis provision on people’s everyday activities.

• Presentation Conference Type: Poster
• Conference Name: International Conference on Ambulatory Monitoring of Physical Activity and Movement (ICAMPAM)
• Start Date: Jun 18, 2024
• Deposit Date: Apr 1, 2025
• Peer Reviewed: Not Peer Reviewed