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

Abstract

Background: Individuals with disabilities in low- and middle-income countries face barriers to rehabilitation services, including prosthetic care. Many countries, such as Ecuador, have adapted policies toward achieving universal health care coverage. For optimal functional outcomes, understanding the physical potential of prosthetic users is critical for appropriate prosthetic services.

Objective: To determine the association between the functional level of Ecuadorians with lower-limb amputations and the functional level of their prosthetic componentry.

Study design: Retrospective study.

Methods: A data set containing functional level (K-Level) of Ecuadorians with lower-limb amputations and the K-Level of their prosthesis was analyzed.

Results: A diverse cohort of 164 participants with unilateral lower-limb amputation was recruited. Most participants were male (76.8%) with transfemoral amputations (56.1%) due to traumatic causes (51.2%). There was a small, positive, and statistically significant correlation between participants' functional levels and prosthetic componentry. Participants's functional levels were typically superior (median = 3) to their prostheses' functional abilities (median = 1), and 37.2% of participants did not have a prosthesis at the time of assessment.

Conclusions: These data indicated that participants whose physical ability exceeded basic ambulation lacked access to prostheses to match their functional abilities. The detailed disparity between physical potential and prosthetic access derived from the study's analysis supports investment into high functioning prosthetic componentry and further investigation into where gaps in care exist.