User Perceptions during Adaptation to a Novel Prosthetic Foot: A Qualitative Study

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Abstract
Background: Mobility is challenging for individuals with lower extremity amputations due to human movement variability, environmental factors, and aspects of prosthetic foot performance. Designing and testing novel prostheses offers an opportunity to qualitatively evaluate users' experiences with the technology in their lived environment. Objective: The aim was to understand the lived experiences of people with lower extremity amputation during a clinical trial of a novel prosthetic foot. Study Design: This study was a secondary phenomenological analysis of semi-structured interview data collected during a clinical trial. Methods: This study included individuals with unilateral, below-knee amputations and mobility levels of K3 or K4. Participants used a newly designed prosthetic foot in home and community for 2 weeks, followed by 2 weeks using their usual prosthesis. Participants recorded their daily activities and challenges in a logbook. Semi-structured interviews were conducted after the investigational foot was used and at the study's conclusion. Interviews were transcribed verbatim and independently coded by at least three researchers using an inductive coding scheme until themes emerged. Results: Thirty-one participants took part in this study. Key themes included (1) adjusting to the prosthesis, (2) fluid movement in everyday life, (3) testing prosthesis limits, and (4) natural feel of the prosthesis. Some participants reported experiences consistent with prosthetic embodiment. Conclusion: Gathering qualitative perspectives on novel prosthetic technology is essential to understanding user priorities, adaptation strategies, and functional needs. Participants identified both advantages and drawbacks in the new prosthetic foot design while noting challenges in trialing it. This research contributes to understanding the process of adapting to a new prosthesis and the impact of prosthetic feet on users' daily lives. Clinical Relevance Statement: Users identified opportunities for longer, real-world trial periods of prosthetic technology as critical to understanding the contextual benefits and challenges associated with novel prosthetic design options. ( J Prosthet Orthot . XXXX;X:XX–XX)

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