Abstract
Introduction:Lower limb amputations have a profound impact on the quality of life (QoL) of the patients. This study was done to assess the QoL of patients with transtibial (below-the-knee) amputations (TTA) and transtibial amputees fitted with prosthesis.Material and Methods:A case-control study of patients who had undergone TTA from 2015 to 2018 was conducted in Raja Isteri Pengiran Anak Saleha Hospital (RIPAS). Complete data was available for 30 subjects and it was compared with 30 diabetic, non-amputee patients matched for age and gender. QoL was assessed using the RAND 36-Item Health Survey (SF-36) and the functional outcome of prosthesis-fitted transtibial amputees was assessed using the Houghton Scale.Results:Almost all cases of TTA were a result of vascular problems related to diabetes and chronic renal disease (n=29; 97%). Eighteen (60%) participants were fitted with prosthesis and 15 (50%) reported having phantom pain. QoL of participants was found to be significantly lower than that of age and sex-matched diabetic non-amputees with regards to physical functioning, role limitation due to physical health, emotional well-being, social functioning, and bodily pain. The mean Houghton Score for participants fitted with prosthesis was 4.89 (SD= 2.83) suggesting low functional outcome.Conclusion:TTA has a negative impact on the QoL of patients, especially in terms of functionality. The availability of prosthesis does not significantly improve the quality of life except in the physical functioning domain. Emotional well-being should be emphasised more in the rehabilitation process as this study found poor emotional well-being among participants.
Highlights
Lower limb amputations have a profound impact on the quality of life (QoL) of the patients
Of the 30 participants with TTA included in this study, 19 (63.3%) were males and 29 (96.7%) were Malay with a mean age of 57.4 years (SD= 7.43). 29 (96.7%) had diabetes, 22 (73.3%) had hypertension and 19 (63.3%) had hyperlipidaemia, whereas almost all had vascular problems related to diabetes and chronic kidney disease as the cause of Quality of Life TTA Brunei their amputation. 18 (60%) of the amputees were fitted with prosthesis and 15 (50%) reported having phantom pain while 3 (10%) had problems with wound healing
It was found that TTA participants without prosthesis had significantly lower quality of life scores for the physical functioning domain as measured by the SF-36, than TTA participants with prosthesis
Summary
Lower limb amputations have a profound impact on the quality of life (QoL) of the patients. This study was done to assess the QoL of patients with transtibial (below-the-knee) amputations (TTA) and transtibial amputees fitted with prosthesis. QoL was assessed using the RAND 36Item Health Survey (SF-36) and the functional outcome of prosthesis-fitted transtibial amputees was assessed using the Houghton Scale. QoL of participants was found to be significantly lower than that of age and sex-matched diabetic non-amputees with regards to physical functioning, role limitation due to physical health, emotional well-being, social functioning, and bodily pain. A study of 81 patients in Brunei Darussalam had confirmed that diabetes mellitus was the leading cause of lower limb amputation while TTA was the most common procedure performed[5]
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