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Introducing an adjustable upper limb prosthesis into a Ugandan clinical service: impacts on free living behaviour and prosthetic use

Pickard, N.; Mulindwa, B.; Gracey-McMinn, L.; Granat, M.; Chadwell, A.; Curtin, S.; Howard, D.; Ackers, L.; Ssekitoleko, R.; Kenney, L.

Introducing an adjustable upper limb prosthesis into a Ugandan clinical service: impacts on free living behaviour and prosthetic use Thumbnail


Authors

B. Mulindwa

A. Chadwell

R. Ssekitoleko



Abstract

Access to prosthetic services in Uganda is poor, negatively impacting people with upper limb difference in function, community participation, and employment. Technologies to improve the efficiency and effectiveness of services are needed, but there is very little evidence of potential solutions. Off-the-shelf, adjustable prosthetic sockets, which can be fitted in minimal time without the complexities associated with traditional socket manufacturing, show promise. We tested the feasibility of introducing the Koalaa ALX, a prosthesis for people with trans-radial limb difference, and a peer-to-peer support system into a Ugandan clinical service. Prosthesis-worn and thigh-worn monitors successfully captured concurrent patterns of wear and free-living physical behaviours (including periods at home and away) at baseline, post-fitting, and six months post-fitting. End-of-study interviews captured participants’ experiences. Four of the eight participants had no previous experience using a prosthesis (new users). The ALX could be easily deployed and supported. All participants wore their ALX, with an increase in wear time among new users at six months. Prosthesis donning and doffing events were associated with behavioural changes (e.g., changes in stepping duration). The interviews revealed good levels of satisfaction, though concerns about access to repairs, cleaning, heat discomfort, and long-term support were noted.

Journal Article Type Article
Acceptance Date Mar 31, 2025
Online Publication Date Apr 4, 2025
Deposit Date Apr 15, 2025
Publicly Available Date Apr 15, 2025
Journal Scientific Reports
Electronic ISSN 2045-2322
Publisher Nature Publishing Group
Peer Reviewed Peer Reviewed
Volume 15
Issue 1
Pages 11585
DOI https://doi.org/10.1038/s41598-025-96779-w
Keywords Real-world behaviours, Prosthetics, Appropriate technology, Upper-limb, Uganda

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Publisher Licence URL
http://creativecommons.org/licenses/by/4.0/

Copyright Statement
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.





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