title: The roles of predisposing characteristics, established need, and enabling resources on upper extremity prosthesis use and abandonment.
abstract: OBJECTIVE
  Prosthesis use and abandonment is a complex function of variables defining the contextualized individual. This review presents a comprehensive panoramic of these factors as related to the management of upper limb deficiency. Me
  
  
  METHODS
  nderson's model for health service utilization was used to frame prosthesis use and abandonment as a function of (1) predisposing characteristics of the individual (e.g. gender or level of limb loss); (2) established need, as characterized by lifestyle- and age-related demands; and (3) enabling resources (e.g. clinical and social). English-language articles pertaining to these components were identified in a search of Ovid, PubMed, ISI Web of Science and www.scholar.google.com (1980-November 2006) for key words upper limb and prosthesis. Approximately 90 articles were included as evidence in this review. Re
  
  
  RESULTS
  ersonal and contextual factors are critical determinants of prosthesis acceptance. While the influence of some factors (i.e. lifestyle, level of limb loss), is strongly supported in the literature, the impact of others, (i.e. age of fitting, efficacy of training protocols), remain controversial. Co
  
  
  CONCLUSIONS
  nhanced understanding of these factors is required to optimize clinical practices, guide design efforts, and satiate demand for evidence-based measures of intervention. Future research should comprise of controlled, multifactor studies adopting standardized outcome measures and providing comprehensive descriptions of population characteristics.
authors.affiliation: Bloorview Research Institute, Toronto, ONT, Canada.
authors.forename: Elaine
authors.initials: E
authors.lastname: Biddiss
authors.forename: Tom
authors.initials: T
authors.lastname: Chau
mesh_terms: D000367:Age Factors; D004867:Equipment Design; D006801:Humans; D009983:Orthopedic Equipment / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D012737:Sex Factors; D012944:Social Support; D034941:Upper Extremity