Evaluation of device quality and satisfaction at delivery during an intensive fitting camp and 3 month follow up

Prosthetic limbs enable mobility, independence, and social participation. Fitting camps provide mobility assistive devices to many individuals in intensive sessions, but concerns exist regarding device design, fabrication quality, and the required rehabilitation and aftercare. This study evaluated a fitting camp in Cambodia where 525 people received prosthetic limbs. Using a multiple-methods study, we assessed device quality and client satisfaction at provision and at a 3-month follow-up structured interview. At provision, many devices failed to meet the International Society for Prosthetics and Orthotics standards for safety, workmanship, and client satisfaction. Structured interviews revealed dissatisfaction with function (26%), workmanship (34%), and fit (56%). At follow-up, 45% of clients considered their new device comfortable or somewhat comfortable, while 36% reported discomfort or pain. Among those with a previous prosthesis, 80% preferred it. Usage rates of the provided device were low; 81% reported not very often, rarely, or never, whereas of 280 clients with a previous device, 87% reported often or always using it. At the three-month follow-up, 29% of clients were using a previous device observed at the camp as unused, broken, painful, or poorly fitting, suggesting many individuals rely on an inadequate or dangerous prosthesis. These findings indicate that previously reported shortcomings in quality and satisfaction of prostheses delivered at intensive fitting camps persist, and raise new questions about inclusiveness of patient selection and effectiveness of funding use. Inadequate training and aftercare may exacerbate these issues, increasing the strain on local physical rehabilitation services or leaving vulnerable clients without support. Future camps should be fully integrated with the existing services and should leave behind adequate materials and components for repairs and replacement. Screening of patients for need is essential, as is engagement of the practitioner who will be expected to continue with the care of the patients.