Water activity limbs

With advances in technology there is an increasing availability of Water Activity Limbs (WALs) and subsequently a greater number of requests for their provision. This study aims to establish a national consensus for indications, recommended best practice and procedures. The study was conducted with 2 rounds of questionnaires sent to 40 doctors, prosthetists and therapists each. The first questionnaire had a list of possible tasks requiring a WAL and respondents were asked to record their personal rating for prescription of each of the indications. Following analysis of the 91 responses, a list of indications, guidelines and procedures was sent to the same 120 respondents, enquiring whether they agreed or disagreed to each recommendation. The tasks orientated questionnaire showed that more than 50% of respondents considered occupation as an absolute indication. Other indications were some specific water sports. Occasional swimming and beach activity were only considered as possible indications. Showering was not considered an indication. The second questionnaire showed an overwhelming agreement to most of the procedures and indications recommended except social reasons for leisure. The authors present recommendations for prescription of WALs as guidelines and procedures based on the national consensus amongst peers. They also recommend a process for establishing evidence in a speciality where there is very little published evidence to recommend best practice.