Activity and Participation, Bimanual Function, and Prosthesis Satisfaction are Strong Predictors of General Well-Being Among Upper Limb Prosthesis Users

OBJECTIVE: To determine the role of multiple factors on general well-being for upper limb prosthesis users. DESIGN: Retrospective cross-sectional observational design. SETTING: Prosthetic clinics across the United States. PARTICIPANTS: At the time of analysis, the database consisted of 250 patients with unilateral upper limb amputation seen between July 2016 and July 2021. INTERVENTION: Not applicable. MAIN OUTCOMES MEASURES: Dependent variable: well-being (Prosthesis Evaluation Questionnaire- Well-Being). Independent variables included in analysis: activity and participation (Patient Reported Outcomes Measurement Information System [PROMIS] Ability to Participate in Social Roles and Activities), bimanual function (PROMIS-9 UE), prosthesis satisfaction (Trinity Amputation and Prosthesis Experience Scales-Revised; TAPES-R), PROMIS pain interference, age, gender, average daily hours worn, time since amputation, and amputation level. RESULTS: A multivariate linear regression model using a forward enter method was applied. The model included 1 dependent variable (well-being) and 9 independent variables. Within the multiple linear regression model, the strongest predictors of well-being were activity and participation (β=0.303, P<.0001), followed by prosthesis satisfaction (β=0.257, P<.0001), pain interference (β=-0.187, P=.001), and bimanual function (β=0.182, P=.004). Age (β=-0.036, P=.458), gender (β=-0.051, P=.295), time since amputation (β=0.031, P=.530), amputation level (β=0.042, P=.385), and hours worn (β=-0.025, P=.632) were not significant predictors of well-being. CONCLUSION: Reducing pain interference and improving clinical factors such as prosthesis satisfaction and bimanual function with their associated effects on activity and participation will positively affect the well-being of individuals living with upper limb amputation/congenital deficiency.