User needs, prosthetic design priorities, and functional movement assessments for children with above/through-knee limb absence in Cambodia: a mixed methods interactive interview.

Abstract

Prosthetic user needs for children with above/through-knee (A/TK) limb absence in low-resource environments have not been defined at a discrete component level. This knowledge gap hinders design innovation. Proxy-reports from other stakeholders are insufficient. This study aims to define these user needs through interactive interviews with children in Cambodia. Children were recruited across three centres in Cambodia. A novel interactive interview guide including card games provided quantitative and qualitative data. A functional movement assessment provided insight on mobility. Qualitative data underwent thematic analysis. Quantitative data was analysed with descriptive statistics. Eight children were recruited (87.5% male) with a mean age of 14.1 years (SD = 2.80, range: 9.3-17.4). 75% used polypropylene technology. Seven user need interview themes were identified: prosthesis appreciation; appearance; sport and running; daily activity challenges; articulating knee instability; pain/discomfort; and socket use. The mean functional movement score was 88.0% (SD = 6.7). Children ranked walking faster, kneeling, and being less tired as their top three priorities for change. Children were successfully engaged through an interactive interview. Design innovation is required for more stable prosthetic joints with a greater range of motion and appropriate appearance. Identified improvements will increase quality of life and access to cultural activities and sport.