Impact of Improving Footwear Options for Women Veterans with Amputations

Women with amputations receive more frequent prosthetics care, but are less satisfied with the fit, comfort, and appearance of their prostheses than men. These findings are not surprising as most prosthesis components are not gender-specific and seem to have been designed for men. Components like prosthetic feet are made from molds, and it is prohibitively expensive for prosthetics companies to provide a high number and variety of foot shape options. Recent surveys indicate that women Veterans with leg amputations are unable to wear many of the types of footwear they desire to wear due to limitations of the prosthetic foot. Women Veterans who have greater perceived challenges with how their prosthesis affected footwear options also experienced significantly more body image concerns and participated less in daily activities. This project will assess the impact of a new prosthesis system including a modular prosthetic ankle that can be used interchangeably with several 3D-printed feet. The prosthetic feet are customized to fit a wide range of footwear, including shoes of different heel heights and widths. To change footwear, the user simply removes the prosthetic ankle from one foot-shoe combination and connects it to another, without the need for tools or modifications to the prosthetic alignment. This new prosthesis system dramatically improves footwear options for persons using leg prostheses, enabling potential to increase body image and community participation for women Veterans with leg amputations. In this study, women Veterans with amputations will be recruited from a national sample to test the modular ankle – 3D printed feet system. Informed consent and baseline measures will be collected remotely. Women will then travel to the Minneapolis VA to be fitted with the novel prosthesis system and shoes of their choice. Accommodation to the new prosthesis system will take place over several days in Minneapolis with close clinical supervision. After returning home, women Veterans with amputations will be followed remotely for a period of 6-months to track their outcomes. The study will test the hypotheses that improving footwear options with our novel prosthesis will improve body image and participation in women Veterans with amputations. Qualitative interviewing and photovoice will also be conducted throughout the study to understand the benefits and barriers to using this new prosthesis system.