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

PURPOSE: 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. MATERIALS AND METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.