McDonald C.L, Cheever S.M , Morgan S.J., Hafner B.J. PROSTHETIC LIMB USER EXPERIENCES WITH CROSSOVER FEET: A FOCUS GROUP STUDY TO EXPLORE OUTCOMES THAT 
MATTER. CANADIAN PROSTHETICS & ORTHOTICS JOURNAL, VOLUME 1, ISSUE 2, 2018; ABSTRACT, ORAL PRESENTATION AT THE AOPA’S 101ST NATIONAL ASSEMBLY, SEPT. 26-
29, VANCOUVER, CANADA, 2018.   DOI: https://doi.org/10.33137/cpoj.v1i2.32042                                                                           

 

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AOPA’S 101 ST NATIONAL ASSEMBLY ABSTRACTS, SEPTEMBER 26-29, VANCOUVER, CANADA, 2018 
 

ABSTRACT (ORAL PRESENTATION) 

PROSTHETIC LIMB USER EXPERIENCES WITH CROSSOVER FEET: A FOCUS 

GROUP STUDY TO EXPLORE OUTCOMES THAT MATTER 

Cody L. McDonald*, Sarah M. Cheever, Sara J. Morgan, Brian J. Hafner 

Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA. 

* Email:  codym@uw.edu 

DOI: https://doi.org/10.33137/cpoj.v1i2.32042  

 

INTRODUCTION 

 A variety of prosthetic feet are available to meet the 

diverse needs of people with lower limb amputation. 

Outcome measures selected to assess comparative 

effectiveness of prosthetic feet are most often chosen by 

clinicians and researchers.1 Therefore, these measures 

may not reflect the outcomes that are most important to 

lower limb prosthesis users. Qualitative research can give 

voice to prosthesis users and promote the consideration 

of user priorities when selecting outcome measures for 

clinical assessment and research studies. This study 

explored the lived experience and outcomes of 

importance to individuals who have worn both traditional 

energy storing feet and crossover feet. 

METHODS 

Sample: Convenience sample of prosthesis users 

Eligibility criteria: At least 18 years of age, lower limb 

amputation, at least 1 year prosthesis use, and prior use 

of an energy storing foot and crossover foot. Procedures: 

An in-person two-hour focus group was held. All 

procedures were approved by a UW IRB. Analysis: A 

phenomenological theoretical framework was applied to 

data analysis. Two investigators coded the focus group 

transcript independently, and a third mediated any 

discrepancies. Open coding was used to identify initial 

ideas. Axial coding and inductive reasoning were used to 

identify themes. Transcripts were reviewed to identify 

final themes and representative text. Investigators 

developed a framework of themes and identified 

instruments capable of measuring outcomes that 

mattered to focus group participants. 

RESULTS 

Five people with lower limb amputation (4 

males/1female), aged 41-59 years (mean 45.6±7.7 years), 

and who used a prosthesis daily (mean 15.2±1.1 hours) 

participated in the focus group. Three categories of 

themes arose from this focus group: direct outcomes, 

external influences, and indirect outcomes (Table 1). 

Themes such as balance & stability well matched 

standardized measures. Themes like naturalness and 

peer influence did not align with available measures, 

suggesting that new outcome measures may need to be 

developed. Other themes like endurance and sustained 

gait quality included elements (e.g., time of day, fatigue 

and gait symmetry) that may be challenging to capture 

with current assessment methods. 

Figure 1. Framework of study themes 

mailto:codym@uw.edu
https://doi.org/10.33137/cpoj.v1i2.32042


 

 

McDonald C.L, Cheever S.M , Morgan S.J., Hafner B.J. PROSTHETIC LIMB USER EXPERIENCES WITH CROSSOVER FEET: A FOCUS GROUP STUDY TO EXPLORE OUTCOMES THAT 
MATTER. CANADIAN PROSTHETICS & ORTHOTICS JOURNAL, VOLUME 1, ISSUE 2, 2018; ABSTRACT, ORAL PRESENTATION AT THE AOPA’S 101ST NATIONAL ASSEMBLY, SEPT. 26-
29, VANCOUVER, CANADA, 2018.   DOI: https://doi.org/10.33137/cpoj.v1i2.32042                                                                           

 

2 

 
OPEN  ACCESS 

 

AOPA’S 101 ST NATIONAL ASSEMBLY ABSTRACTS, SEPTEMBER 26-29, VANCOUVER, CANADA, 2018 
 

ABSTRACT (ORAL PRESENTATION) 

CONCLUSION 

Prosthesis user engagement through qualitative research 

can inform selection of outcomes that matter to users. 

Measurement of outcomes that matter may maximize 

clinicians’ and researchers’ ability to assess the effects of 

prosthetic interventions on users’ lives. 

REFERENCES 

1.Hafner BJ. Energy storage and return prostheses: does 

patient perception correlate with biomechanical analysis? Clin 

Biomech. 2002; 17(5), 325-44. DOI: 

https://doi.org/10.1016/S0268-0033(02)00020-7 

DISCLOSURE 

This work was funded by a Walter C. and Anita C. Stolov 

Award and an Orthotics and Prosthetics Outcomes Research 

Award (No. W81XWH-15-1-0458). 

 

 

 

https://doi.org/10.1016/S0268-0033(02)00020-7