The Development and Study of Rehabilitation Education Materials for Persons with Lower Limb Amputation in Developing Nations: A Pilot Investigation

Document Type

Peer-Reviewed Article

Publication Date



Physical Therapy


Introduction: Prosthetic rehabilitation education materials for persons with low literacy skills in developing countries do not currently exist. The purpose of this study was to create and test such materials.
Methods: Working in collaboration with a United States based non-profit organization, LIMBS International, researchers created a clinician manual, clinic posters and a patient take-home pamphlet using effective, proven methodologies known to the field. Because of constraints related to the international test population, only the content of the posters was tested. A questionnaire was developed to assess acceptability of the posters using poster ratings, and understandability using object identification and sequence comprehension questions. Four test populations included persons with amputation in the United States, Peru, and Eastern Africa, and students with English as a second language in the United States.
Results: Poster ratings were high (87-96%) among all test groups. Sequence comprehension scores were 89% for United States and 86% for Peruvian patients and 56% for United States students. Sequence comprehension was not tested in Africa due to time constraints. Identification scores were varied among groups (56-72%).
Conclusion: Field testing revealed that the posters were suitable for all test populations and identified which images should be modified to increase understandability. Multi-modal testing is a practical way to identify suitability and understandability of education materials. This study illustrates the methodological process of design of education materials for persons with low health and reading literacy skills.


At the time of publication Diana Veneri was affiliated with University of Hartford.


International Journal of Health Science and Research