Prosthesis abandonment has been well studied among upper-limb amputees, who ditch their devices at distressingly high rates. But people with lower-limb loss routinely quit using their prostheses, too—as many as 22 percent, according to one recent study. And roughly one-third only use their device on a limited basis within the home.
A new paper attributes these trends to a single root cause: lack of prosthesis embodiment. Authored by an interdisciplinary team of healthcare clinicians and biomedical engineers, the paper addresses a troubling disconnect: Although the prosthetics industry is awash in innovations that tend to promote embodiment, there’s a lack of attention to ensuring that next-gen products truly address patients’ everyday needs. “A more rigorous [approach] is needed,” they argue, “moving beyond isolated technological advancements to explore holistic approaches that integrate these tools into a standardized care pathway.”
The authors identify three major factors that cause amputees to abandon leg prostheses: lack of functional control, lack of sensation, and inadequate comfort (both physical and aesthetic). They also review the variety of solutions that attempt to address these factors, ranging from low-tech interventions (such as stylish prosthetic covers and adjustable sockets) to osseointegration, AMI surgery, and other highly invasive procedures.
Yet in spite of this array of options, the paper argues, the field “lacks a systematized understanding of how these interventions combine or translate into meaningful clinical benefit.” Solutions “must prioritize the individual’s lived experience, rather than solely focusing on biomechanical or neurological metrics.” Without that shift in perspective, the authors conclude, prosthesis abandonment will persist, to the detriment of amputees’ quality of life.
