A disparity in prosthetic access for Ecuadorians with lower-limb amputation

Area of Science:

• Rehabilitation Medicine
• Prosthetics and Orthotics
• Global Health

Background:

• Individuals with disabilities in low- and middle-income countries face significant barriers to essential rehabilitation and prosthetic services.
• Ecuador is pursuing universal health care coverage, making understanding prosthetic needs crucial for optimal outcomes.
• Assessing the physical potential of prosthetic users is vital for providing appropriate and effective prosthetic care.

Purpose of the Study:

• To investigate the relationship between the functional capacity of individuals with lower-limb amputations in Ecuador and the functional capabilities of their prosthetic devices.
• To identify disparities between the physical potential of amputees and the available prosthetic technology.

Main Methods:

• A retrospective study analyzing a dataset of 164 participants with unilateral lower-limb amputations in Ecuador.
• Evaluation of the functional level (K-Level) of participants and their corresponding prosthetic componentry.
• Statistical analysis to determine the correlation between patient functional levels and prosthetic functional abilities.

Main Results:

• A diverse cohort was studied, with most participants being male (76.8%) with transfemoral amputations (56.1%) often due to trauma (51.2%).
• A statistically significant, though small, positive correlation was found between participants' functional levels and their prosthetic componentry.
• Participants' functional levels (median K-Level 3) frequently surpassed their prostheses' capabilities (median K-Level 1), with 37.2% lacking a prosthesis at assessment.

Conclusions:

• The study reveals a significant gap where individuals with physical abilities beyond basic ambulation lack access to prostheses that match their functional potential.
• There is a clear disparity between the physical capabilities of amputees and the functional level of their prosthetic devices.
• Findings support increased investment in high-functioning prosthetic componentry and further research to identify and address gaps in prosthetic care for amputees in Ecuador.