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Updated: Jan 6, 2026
A Structured Rehabilitation Protocol for Improved Multifunctional Prosthetic Control: A Case Study
Published on: November 6, 2015
Durability challenges and mitigation strategies for paediatric prostheses - cambodian prosthetist experiences and
Caitlin E Edgar1, Claudia Ghidini1, Carson Harte2
1The Centre for Paediatric Blast Injury Research, Department of Bioengineering, Imperial College London, UK.
Insights
Durability of prosthetic components is a major challenge for children with lower-limb absence in low-resource settings. Improved designs and local repair services can enhance rehabilitation outcomes.
Area of Science:
- Biomedical Engineering
- Rehabilitation Science
- Global Health
Background:
- Prosthetic component durability is a critical factor for successful rehabilitation in children with lower-limb absence.
- Low-resource environments present unique challenges to prosthetic service delivery and component longevity.
Purpose of the Study:
- To define the challenges associated with prosthetic component durability in low-resource settings.
- To understand current mitigation strategies for prosthetic component failures.
- To inform improved prosthetic design and service delivery for pediatric patients.
Main Methods:
- A convergent mixed-methods approach combining qualitative interviews and retrospective clinical casefile analysis.
- Purposive sampling of 6 prosthetists in Cambodia for qualitative interviews.
- Thematic analysis of interview data and statistical analysis of 62 pediatric clinical casefiles.
Main Results:
- Key themes identified include prosthetic knee and SACH foot durability issues, the need for professional repair expertise, and the benefits of local component supply and repair.
- Clinical casefiles revealed specific component failure points, with significant design-dependent differences in knee problems between local and donated components (p < 0.001).
- Repair solutions for common knee and foot designs were documented.
Conclusions:
- Prosthetist insights, supported by clinical data, highlight durability as a significant challenge.
- Incorporating spare parts and mobile repair services can partially mitigate durability issues.
- Understanding design shortcomings provides crucial evidence for prosthetic designers and manufacturers to improve pediatric prosthetic devices for low-resource settings.
Purpose:
Prosthetic component durability challenges can form a significant barrier to the successful rehabilitation of children with lower-limb absence in low-resource environments. This work aims to define these challenges and understand current mitigation strategies to support improved design and service delivery.
Materials & Methods:
A convergent mixed methods approach was employed. Qualitative interviews were conducted through purposive sampling with 6 prosthetists in Cambodia. Thematic analysis was complemented with data from 62 retrospective paediatric clinical casefiles detailing prosthetic component problems, failure points, and repair solutions. Descriptive and inferential statistics were applied with a significance level of p < 0.05.
Results:
At interview, 5 themes were identified: the challenge of prosthetic component durability; prosthetic knees; SACH feet; repairs require professional expertise; and local supply/repair of componentry is beneficial. Clinical casefiles revealed component failure points. The distribution of knee problems was design specific and showed significant differences between local polypropylene and donated modular componentry (p < 0.001). Repair solutions are provided for knee and feet designs.
Conclusion:
Prosthetists provided critical insight which was supported with clinical evidence. Durability is a significant challenge which can be partially alleviated through inclusion of spare parts and mobile outreach repairs. Clarity on current design shortcomings provides evidence for designers and manufacturers.
