The amputation of a lower extremity is a significant and life altering event that has a major impact to a person's mobility and subsequent community involvement. Amputees electing to use a prosthesis benefit from improved mobility, community involvement, and improved fitness due to increased activity, but are reliant on an unyielding prosthetic socket that is often unable to adapt to residual limb volume change. This convergent mixed methods collective self-controlled case study evaluated the applicability of the Technology Acceptance Model (TAM) on a sample of community-ambulator amputees (n = 7) and determined if an experimental Smart Adaptive Socket System (SASS) can improve use of a prosthesis. A mixed methods approach was employed due to its alignment with clinical practice and its strength for research involving small samples. The TAM was adapted using an existing validated scale for amputees. The Prosthesis Evaluation Questionnaire (PEQ) has several subscales that align with variables in the TAM. Non-PEQ values were used to quantify variables that did not align with the PEQ subscales, namely intervention preference and activity data from a StepWatch Activity Monitor (SAM). Additionally, participants were asked for qualitative feedback to better understand their experience with the study and interventions. Participant-reported and performed measures were collected and analyzed. Ease of use and usefulness decreased for the SASS 21.9% and 9.8% respectively while activity increased 22.9%, though none were significant changes. Qualitative analysis found several themes that impacted participants' experience with SASS and identified design features that require improvement in future iterations of the technology. Analyses between the quantitative and qualitative data found weak relationships between qualitative themes present and quantitative findings (positive themes and usefulness r2 = 0.36, positive themes and ease of use r2 = 0.34, combined themes and usefulness r2 = 0.28, and combined themes and ease of use r2 = 0.19). Despite low statistical significance, this study gained useful data that supports use of TAM for amputation research and will positively impact the future development of the experimental system largely due to the selection of a mixed methods research design that facilitated collection, analysis, and triangulation of both quantitative and qualitative data.
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Doctor of Philosophy (Ph.D.)
College of Community Innovation and Education
School of Public Administration
Public Affairs; Health Services Management and Research
Length of Campus-only Access
Doctoral Dissertation (Campus-only Access)
Carroll, Michael, "Increasing Transtibial Amputee Community Involvement Through the Use of a Smart Adaptive Socket System: A Mixed Methods Research Study" (2021). Electronic Theses and Dissertations, 2020-. 482.