Table 3. Summary of the sample characteristics, used methodologies and quality assessment from included studies.

Study	Sample size	Age	Gender	Origin of limb loss	Level of limb loss	Type of prosthesis	Wearing time prosthesis	Country (ISO-code)	Data collection technique	Data analysis	CASP criteria unmet A
Zheng et al.(2019) [22] B	11	Median: 45 years	9 M;	2 ULRD;	1 Wd;	Not reported	Not reported	USA	Focus groups and semi-structured phone interviews	Qualitative content analysis with an inductive approach	None
		Range: 27–65 years	2 F	9 AA	6 Tr;
					1 Ed;
					1 Th;
					1 Bi Tr;
					1 Dw
Widehammar et al. (2018) [48]	13	62% ULRD (n = 8; median: 33 years; range: 20–47 years)	9 M;	8 ULRD;	10 Tr;	13 ME	6 Daily;	SWE	Semi-structured face-to-face or phone interviews	Qualitative content analysis with an inductive approach	3
			4 F	5 AA	3 Th		2 only at work;
							3 only in specific situations;
		38% AA (n = 5; median: 48 years; range: 27–74 years)
							2 non-wearer
Schweitzer et al. (2018) [19] B	1	Not reported	1 M	1 AA	1 Tr	BP and MHP	10–12 hours a day	CHE	Case-report	Not applicable	Not applicable
Resnik et al. (2018) [11]	3	Median: 29 years	3 F	2 ULRD;	3 Tr	2 MHP, DEKA-arm and CP;	Not reported	USA	Semi-structured face-to-face interviews	Four of the authors compared each case to identify categories (called constant comparison) and applied the grounded theory approach	3, 4, 5 and 6
		Range: 24–32 years		1 AA
						1 SHP, DEKA-arm and CP
Davis & Onge (2017) [20] B	1	46 years	1 F	1 ULRD	1 Tr	1 SHP	Not reported	USA	Commentary of prosthesis user	Not applicable	Not applicable
Benz et al. (2016) [24]	7	Range: 41–65 years	5 M;	1 ULRD;	5 Tr;	7 ME; (of whom 1 with ME and CP)	5 daily;	USA	Individual interviews	Step 1: initial coding, method not clearly mentioned	3, 4, 6, 8 and 9
			2 F	6 AA	2 Bi Tr		1 weekly;
							1 monthly
										Step 2: topic modeling using Latent Dirichlet Allocation (LDA), which is a form of machine learning
Nagaraja et al. (2016) [40] B	60	10% children (n = 6; mean: 6 years; SD 0.8 years);	54 M;	8 ULRD;	45 below elbow;	93% CP or BP;	Not reported	IND	Phone or face-to-face survey with open-ended questions	Not clearly mentioned	3, 5, 6, 8 and 9
			6 F C	52 AA C
					15 above elbow B	7% otherC
		85% male adults (n = 51; mean: 31 years; SD: 10.1 years);
		5% female adults (n = 3; mean: 21 years; SD 5.3 years)
Deijs et al. (2016) [41] B	8	Mean: 50 years	6 M;	3 ULRD;	8 Tr	8 SHP	> 4 hours daily	NL	Semi-structured face-to-face interviews	Not clearly mentioned	6
		SD: 14 years	2 F	5 AA
Luchetti et al. (2015) [23] B	6	Median: 47 years	6 M	6 AA	6 Tr	6 SHP and MHP	> 8 hours daily	ITA	Clinical face-to-face interviews;	Qualitative content analysis using the ideographic case study approach of the Interpretative Phenomenological Analysis	3, 4, 5, 6 and 8
		Range: 35–65 years
Wijk & Carlsson (2015) [49]	13	Mean: 43 years	5 M;	6 ULRD;	13 Tr	6 ME;	13 daily users, of whom 7 wear prosthesis whole day	SWE	Semi-structured face-to-face interviews	Qualitative content analysis	6
		Range: 29–71 years	8 F	7 AA		5 CP;
						2 both
Resnik et al. (2014) [45] D, E	37	64.9% Gen 2 (n = 24; mean: 44.4 years; SD: 16.9 years)	32 M;	Not reported	9 Tr;	All DEKA-arm + other prosthesis (unknown which type)	18 full-time;	USA	Face-to-face survey with open-ended questions	A qualitative approach to content analysis, followed by a cross-case analysis to compare the users’ perspectives	3, 5 and 6
			5 F		9 Th;		14 part-time;
					10 Shd;
		35.1% Gen 3 (n = 13; mean: 46.4 years; SD: 16.4 years)			4 Bi
							5 non-wearer
Horst & Hoogsteyns et al. (2014) [21] B	7	Not reported	Not reported	Not reported	Not reported	Not reported	Not reported	NL	Biographical face-to-face interviews	Biographic Narrative Interpretation Method	1, 4, 7 and 9
Vasluian et al. (2013) [44] B	12	Range: 17–20 years	4 M;	12 ULRD	12 Tr	3 ME;	1.5–12 hours daily; 7 non-wearer	NL	Online focus group interviews	Framework approach	None
			8 F			2 CP;
						7 none
Waldera et al. (2013) [43] B	17	Only the age at amputation was reported:	Not reported	17 AA	1 Wd;	Not reported	11 Wearer;	USA	Focus group and face-to-face or phone interviews	Inductive thematic analysis	8
					7 Tr;		6 non- wearer
					3 Th;
		<20 years: 17.6%			2 Shd;
		20–29 years: 23.5%			3 Bi;
		30–39 years: 17.6%			1 Dw
		40–49 years: 5.9%
		50–59 years: 5.9%
		≥ 60 years: 5.9%
		Unknown: 23.5%
Bouffard et al.(2012)	12	Mean: 56.6 years	12 M	12 AA	11 Tr;	1 ME;	3 for 2–6 hours daily;	CAN	Focus group meeting and face-to-face semi-structured interviews	Thematic analysis approach	5
		SD: 16.5 years			2 Th (of whom 1 Bi)	8 BP;
[42] B						3 both	9 more than 6 hours daily
Schaffalitzky et al. (2009) [13] B	2	Not reported	1 M;	1 ULRD;	1 Tr; 1 Th	1 SHP;	1 for 4 hours a day for 4 days a week;	USA	Face-to-face interviews using the RGT	‘Contrast Method’ or triadic elicitation, which is a method that’s used in all RGT studies to generate constructs on which to rate elements	4 and 5
			1 F	1 AA		1BP
							1 for 18 hours a day for 7 days
Saradjian et al. (2008) [47]	11	Median: 54 years	11 M	11 AA	1 Wd;	Not reported	At least weekly	UK	Semi-structured face-to-face interviews	Interpretative Phenomenological Analysis	7
		Range:			5 below elbow;
		31–64 years
					4 above elbow;
					1 Shd
Kyberd et al. (2007) [12] B	113	16–20 years: 9%	68 M;	Not reported	65 Wrist;	30 ME;	76% for > 8 hours daily, of whom 46% for > 12 hours daily;	SWE, UK	Postal questionnaire with open-ended questions	Not clearly mentioned	1, 3, 6 and 7
		21–30 years: 12%	40 F;		35 Elbow;	68 CP;
		31–40 years: 20%	5 missing responses		8 Shoulder;	15 other
		41–50 years: 13%			5 missing responses
		51–60 years: 22%
		61–70 years: 16%
							9% only occasional; others not reported
		70–80 years: 4%
		81+ years: 3%
		Missing responses: 3%
Biddiss et al. (2007) [9] B	145	Mean: 43 years	Not reported F	41% ULRD	Not reported F	81 ME;	Not reported	CAN, USA, NL	Online or paper questionnaire with open-ended questions	Not clearly mentioned	6
		SD: 15 years				58 BP;
						38 CP;
						11 other

^A CASP criteria: (1) Was there a clear statement of the aims of the research?; (2) Is a qualitative methodology appropriate?; (3) Was the research design appropriate to address the aims of the research; (4) Was the recruitment strategy appropriate to the aims of the research; (5) Was the data collected in a way that addressed the research issue?; (6) Has the relationship between researcher and participants been adequately considered?; (7) Have ethical issues been taken into consideration?; (8) Was the data analysis sufficiently rigorous?; (9) Is there a clear statement of findings?; (10) How valuable is the research?

^B Only qualitative parts of the study about experiences of the target population with commercially available prostheses were included, other parts of the study were not included in this overview.

^C The pediatric group was not analyzed separately, so this group (n = 6) is included in the results shown here.

^D Only the part of the study where the DEKA arm was compared with their current prosthetic device was included in the meta-synthesis.

^E This study included persons fitted with the Gen 2 and Gen 3 DEKA arm, 5 participants were included in both parts (Gen 2 and Gen 3)

^F Not reported separately for the relevant population of this review.

ISO-code, country code assigned by the International Organization for Standards; CASP, The Critical Appraisal Skills Programme qualitative research checklist; SD, standard deviation; ULRD, upper limb reduction deficiency; AA, acquired amputation; M, male; F, female; Tr, transradial; Th, transhumeral; Shd, shoulder disarticulation; Ed, elbow disarticulation; Wd, wrist disarticulation; Bi, bilateral; Dw, distal from wrist; SHP, standard myoelectric hand prosthesis (with only one grip function); MHP, multi-grip myoelectric hand prosthesis; ME, myoelectric (unknown which subtype); BP, body-powered prosthesis; CP, cosmetic/passive prosthesis; RGT, repertory grid technique; USA, United States; IND, India; UK, United Kingdom; CHE, Switzerland; SWE, Sweden; NL, Netherlands; CAN, Canada; ITA, Italy.