Life In Lower Limb Amputees Research Articles

Mental Health Status and Quality of Life in Lower-Limb Amputees With Diabetes.

To compare mental health status and quality of life in lower-limb amputees versus nonamputees among participants with diabetes mellitus. We included 38 participants with prior minor amputation (group 1) and 38 participants without amputation /history of amputation (group 2). These were interviewed twice using 2 questionnaires to screen for mental health status and quality of life (Self Reporting Questionnaire 20-SRQ20 and EQ-5D-5L). Interviews were carried out 1 week and 6 months after amputation. The mean SRQ20 score for group 1 at 1 week postamputation was 8.50 (diagnostic of a mental health disorder), while it was 1.34 for group 2. At 6 months, mean SRQ20 for group 1 decreased to 5.42, indicating a decrease in psychological distress. A significant difference in the mean values for each dimension of the EQ-5D-5L between groups 1 and 2 indicated that amputees had a poorer quality of life at 1 week and at 6 months. Mental health and quality of life are negatively affected at 1 week after minor lower-limb amputation in diabetes. At 6 months, some improvement in mental health distress was seen, indicating that these individuals had adapted to the disability.

What Is Hidden behind Amputation? Quanti-Qualitative Systematic Review on Psychological Adjustment and Quality of Life in Lower Limb Amputees for Non-Traumatic Reasons.

This systematic review aims to investigate Quality of Life (QoL)/Health Related Quality of Life (HRQoL) and psychological adjustment in non-traumatic lower limb amputees (LLA). PubMed, Scopus, and Web of Science databases were used for the literature search. Studies were read and analysed using the (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) PRISMA statement procedure. The literature search retrieved 1268 studies, of which 52 were included in the systematic review. Overall, psychological adjustment, especially depression with or without anxiety symptoms, influences the QoL/HRQoL in this clinical population. Other factors influencing QoL/HRQoL include subjective characteristics, physical aspects, the cause and level of the amputation, relational aspects, social support, and the doctor-patient relationship. In addition, the patient's emotional-motivational status, depression and/or anxiety symptoms, and acceptance play a key role in the subsequent rehabilitation process. In LLA patients, psychological adjustment is a complex and multifaceted process, and QoL/HRQoL may be influenced by various factors. Shedding light on these issues may provide useful suggestions for promoting clinical and rehabilitative interventions that may be tailored and effective in this clinical population.

Quality of life in lower limb amputees: a cross-sectional study from a tertiary care center of South India.

Various literature have dealt with the physical aspect of amputation and the functional outcome after amputation. There are a few studies that give focused attention to the quality of life (QOL) of amputees. These studies are mostly from the developed countries. This study analyzed amputation as a whole and how it affects an individual physically, psychologically, emotionally, and socially, which would enable the health care providers to help the amputees to attain a better QOL. Cross-sectional study. This cross-sectional study was conducted on lower limb amputees. Data were collected using a proforma for demographic details and two pretested questionnaires-the World Health Organization QOL-Bref and prostheses-specific Trinity Amputation and Prosthesis Experience Scales-Revised questionnaires. The data were analyzed using SPSS software, version 20. Amputation significantly affects all domains of the QOL. Age was a significant determinant of QOL of amputees, and it was found that the QOL decreased with an increase in age. 48.1% of the amputees were using a prosthetic device, and they were found to have a significantly better QOL. The prevalence of residual limb pain and phantom limb pain was 52.9% and 37%, respectively. Nearly half of the population perceived that their QOL was neither poor nor good. The QOL of the physical domain was better than the other domains. The most important factors that were found to be associated with QOL of amputees were age, duration since amputation, and use of prosthesis.

Survey of transfemoral amputee experience and priorities for the user-centered design of powered robotic transfemoral prostheses

BackgroundTransfemoral amputees experience a complex host of physical, psychological, and social challenges, compounded by the functional limitations of current transfemoral prostheses. However, the specific relationships between human factors and prosthesis design and performance characteristics have not yet been adequately investigated. The present study aims to address this knowledge gap.MethodsA comprehensive single-cohort survey of 114 unilateral transfemoral amputees addressed a broad range of demographic and clinical characteristics, functional autonomy, satisfaction and attitudes towards their current prostheses, and design priorities for an ideal transfemoral prosthesis, including the possibility of active assistance from a robotic knee unit. The survey was custom-developed based on several standard questionnaires used to assess motor abilities and autonomy in activities of daily living, prosthesis satisfaction, and quality of life in lower-limb amputees. Survey data were analyzed to compare the experience (including autonomy and satisfaction) and design priorities of users of transfemoral prostheses with versus without microprocessor-controlled knee units (MPKs and NMPKs, respectively), with a subsequent analyses of cross-category correlation, principal component analysis (PCA), cost-sensitivity segmentation, and unsupervised K-means clustering applied within the most cost-sensitive participants, to identify functional groupings of users with respect to their design priorities.ResultsThe cohort featured predominantly younger (< 50 years) traumatic male amputees with respect to the general transfemoral amputee population, with pronounced differences in age distribution and amputation etiology (traumatic vs. non-traumatic) between MPK and NMPK groups. These differences were further reflected in user experience, with MPK users reporting significantly greater overall functional autonomy, satisfaction, and sense of prosthesis ownership than those with NMPKs, in conjunction with a decreased incidence of instability and falls. Across all participants, the leading functional priorities for an ideal transfemoral prosthesis were overall stability, adaptability to variable walking velocity, and lifestyle-related functionality, while the highest-prioritized general characteristics were reliability, comfort, and weight, with highly variable prioritization of cost according to reimbursement status. PCA and user clustering analyses revealed the possibility for functionally relevant groupings of prosthesis features and users, based on their differential prioritization of these features—with implications towards prosthesis design tradeoffs.ConclusionsThis study’s findings support the understanding that when appropriately prescribed according to patient characteristics and needs in the context of a proactive rehabilitation program, advanced transfemoral prostheses promote patient mobility, autonomy, and overall health. Survey data indicate overall stability, modularity, and versatility as key design priorities for the continued development of transfemoral prosthesis technology. Finally, observed associations between prosthesis type, user experience, and attitudes concerning prosthesis ownership suggest both that prosthesis characteristics influence device acceptance and functional outcomes, and that psychosocial factors should be specifically and proactively addressed during the rehabilitation process.

Effects of phantom exercises on pain, mobility, and quality of life among lower limb amputees; a randomized controlled trial

BackgroundThe objective of the current study is to evaluate the effects of phantom exercises on phantom limb pain, mobility status, and quality of life in lower limb amputees treated with mirror therapy and routine physiotherapy.MethodsIt is a randomized controlled trial in which 24 unilateral lower limb amputees (above and below the knee) were randomly assigned to two equal groups i.e., control group (mirror therapy and conventional physical therapy) and experimental group in which, phantom exercises were given, additionally. Physical therapy included conventional therapeutic exercises while phantom exercises include imagining the movement of the phantom limb and attempting to execute these movements Data were collected at baseline, after 2 and 4 weeks of intervention using VAS (pain), AMP (mobility) and RAND SF-36 Version 1.0 (QOL) questionnaires. All statistical analyses were done with IBM SPSS 25.0 with 95% CI.ResultsTwenty-four amputees (17 males and 7 females) participated in this trial. The Mean age of the participants in experimental and control groups was 45.3 ± 11.1 years and 40.5 ± 12.5 years respectively. After the intervention, the pain (VAS score) was significantly lower in the experimental group (p = 0.003). Similarly, the experimental group demonstrated a significantly better score in the “bodily pain” domain of SF-36 (p = 0.012). Both groups significantly (p < 0.05) improved in other domains of SF-36 and ambulatory potential with no significant (p > 0.05) between-group differences.ConclusionsThe Addition of phantom exercises resulted in significantly better pain management in lower limb amputees treated with mirror therapy and routine physiotherapy.Trial registrationThis study is registered in the U.S National Library of Medicine. The clinical trials registration number for this study is NCT04285138 (ClinicalTrials.gov Identifier) (Date: 26/02/2020).

Quality of Life in Lower-Limb Amputees 10 Years After the 2008 Sichuan Earthquake: A Cross-Sectional Study.

The aim of this study was to investigate the long-term outcome of quality of life (QOL) in the lower-limb amputees 10 years after the 2008 Sichuan earthquake. In the cross-sectional study, 66 lower-limb amputees were recruited. The prosthetics-related QOL was assessed using the Prosthetic Evaluation Questionnaire (PEQ) in terms of the scales of utility, appearance, sounds, residual limb health, perceived response, frustration, social burden, ambulation, and well-being. The score of each PEQ subscale was calculated and compared among the cohorts with different demographic characteristics. The PEQ scores showed that the scales of sounds, residual limb health, and frustration were still low in the lower-limb amputees 10 years after the 2008 Sichuan earthquake. The comparison of PEQ scales among cohorts with different demographic characteristics indicated that the potential demographic risk factors, namely, age, marital status, educational level, living independence, and comorbidity, were associated with prosthesis-related QOL. The prosthesis-related QOL of the lower-limb amputees 10 years after the 2008 Sichuan earthquake has been partly documented in this study. The potential demographic risk factors associated with QOL of amputees were also identified. These findings could enhance the understanding of prosthesis-related QOL of lower-limb amputees sustained in an earthquake and facilitate the optimization of post-disaster rehabilitation strategies.

LEVEL OF MOBILITY AND ITS ASSOCIATION WITH QUALITY OF LIFE IN LOWER LIMB AMPUTEES

Objectives: The objective of the study was to explore the levels of mobility and its association with quality of life in lower limb amputees. Methodology: A cross-sectional correlational study was conducted at Chal foundation, Fauji Foundation Hospital and PIPOS on the sample of 230 patients for time duration of six months from January–July 2019. The lower limb amputees aged between 18-57 years, and using prosthesis from more than four months were included in the study. The level of mobility was measured through Self-reporting Prosthetic Limb User Survey of Mobility (SF-PLUS-M) questionnaire, while Prosthetic Evaluation Questionnaire (PEQ) was used to determine the Quality of Life (QOL) among prosthesis users. This data was analyzed by SPSS version 21. Results: The mean age of study participants was 43±14.89 years. The mean PLUS-M score was 39.48±14.33. The results showed a positive significant association between level of mobility and quality of life in lower limb amputees (p&lt;0.001). Conclusion: The study concluded that in Pakistan lower limb amputees has high level of mobility that contributes in improved quality of life.

The effect of post-amputation pain on health-related quality of life in lower limb amputees

Purpose There is conflicting literature on the effect of post-amputation pain on quality of life (QOL) and no available literature on the relationship of pain medications to QOL of amputees in pain. The aims of the study were to compare QOL in lower limb amputees with significant pain to those with minimal pain and compare QOL in amputees on multiple pain medications (≥3 and/or ≥ 40 mg morphine equivalent/day) to those on minimal. Methods Cross-sectional study of amputees (n = 101) utilizing standardized (brief pain inventory, pain self-efficacy, Euro QOL scale), institutional amputee specific questionnaires. Results Post-amputation pain was common (69%), but only 13% of the participants were using more pain medications. High-pain interference and poor self-efficacy were associated with poorer QOL after adjusting for age, gender and cause of amputation. High medication use was associated with high-pain interference and poor self-efficacy, but there was minimal correlation between pain scores and medication usage (p > 0.05). Quality of life was not influenced by high medication usage (p > 0.05 for pain interference; p > 0.05 for self-efficacy). Conclusion Post-amputation pain continues to be a major determinant of QOL in lower limb amputees, but the role of pain medications on an amputee’s QOL remains unclear. IMPLICATIONS FOR REHABILITATION An amputee’s QOL is affected by the severity of their post-amputation pain even beyond six months post their amputation. An amputee with more pain may not necessarily take more pain medications to manage their pain. The amount of pain medications taken may not influence their self-reported QOL. Pain and QOL assessment should be integrated into routine clinical evaluation of adult amputees. Standardized screening tools and/or formative assessment can be utilized for assessing QOL.

Correlation of ambulation potential with quality of life in lower limb amputees

Background: To identify the effect of walking ability on quality of life in lower limb amputees and draw a correlation between prosthesis use, socio economic status and quality of life. It was an Observational Cross sectional study.Methods: Lower limb amputees excluding hip disarticulation and bilateral lower limb amputation, individuals above eighteen years of age who attended rehabilitation research centre outpatient door were interviewed. Structured questionnaire including patient background, amputation characteristics and details regarding prosthesis, was administered along with detailed musculoskeletal examination. Outcome variables: Locomotor capability index (LCI) and timed up and go test (TUG) were used for ambulation potential and Short form 36 (SF 36) for quality of life.Results: Significant correlation was observed between mental health short form 36 score and locomotor capability index (basic and advanced). Poor negative correlation of SF 36 score was observed with age (r=-0.125, p=0.006S). Significant correlation was observed between Physical Health Short Form 36 score and locomotor capability index (basic and advanced), and this correlation was higher and more significant. Poor negative correlation of SF 36 score was observed with age (r=-0.203, p&lt;0.001S).Conclusions: Ability to ambulate is an independent factor that has a positive correlation with quality of life.

The Influence of Social Support on Functional Outcomes and Quality of Life in Lower Limb Amputees

The Influence of Social Support on Functional Outcomes and Quality of Life in Lower Limb Amputees

Reliability and construct validity of the Turkish version of the Trinity Amputation and Prosthetic Experience Scales (TAPES) in lower limb amputees

In Turkey there is no amputee-specific instrument to measure health-related quality of life in lower limb amputees. To evaluate the validity and reliability of a Turkish version of the Trinity Amputation and Prosthesis Experience Scales (TAPES). Outcome study to determine test-retest reliability and construct validity of the adapted Turkish version of the TAPES. After translation/retranslation of the TAPES, the Turkish version of the TAPES was applied to 47 amputees. A quality of life evaluation (Nottingham Health Profile), a satisfaction evaluation (Satisfaction with Prosthesis), and a functional assessment tool (Amputee Mobility Predictor) were also performed and analysed. On the basis of retesting, the Turkish version of the TAPES was observed to be reliable. The first domain of the Turkish version, which includes psychosocial adjustment, activity restriction and satisfaction with the prosthesis, was found to be valid. However, the validity of the second domain could not be analysed. The Turkish version of the multidimensional TAPES survey is valid and reliable in Turkish unilateral lower limb amputees and may be used in clinical situations to assess the needs of amputees. The Turkish version of the TAPES quality-of-life measurement tool for amputees is a valid instrument for assessing the effectiveness of rehabilitation and clinical applications.

Factors affecting quality of life in lower limb amputees

Quality of life (QoL) is increasingly being recognized as an important outcome for rehabilitation programs, and has mainly been used to compare the efficacy of interventions or to compare amputees with other diseased populations. There is relatively a limited number of studies primarily focusing on analyzing the multitude of factors influencing QoL in amputees. To identify important background and amputation related factors which affect quality of life (QoL) in lower limb amputees, and to compare QoL profile of amputees' to that of general population. Cross-sectional. Lower limb amputees 18 years and above from a rehabilitation centre, a limb-fitting centre and four limb-fitting camps were interviewed (n = 605). Structured questionnaires included patient background and amputation characteristics, and the MOS short-form health survey (SF-36) for assessing QoL. The SF-36 was administered to a general adult population using purposive sampling (n = 184). SF-36 PCS and MCS scores were found to be significantly lower for amputees when compared to those for the general population. In this study, employment status, use of an assistive device, use of a prosthesis, comorbidities, phantom-limb pain and residual stump pain were found to predict both PCS and MCS scores significantly, and explained 47.8% and 29.7% of variance respectively. Age and time since amputation accounted for an additional 3% of variance in PCS scores. The abovementioned factors should be addressed in order to ensure holistic reintegration and participation, and to enable the amputees to regain or maintain QoL. Prospective longitudinal studies are recommended to systematically study the change in QoL over time and to assess its determinants. Proper appraisal of abovementioned factors in the rehabilitation programme would assist in establishing a treatment protocol, which would adequately address QoL in amputees.

Skin problems of the stump in lower-limb amputees: 2. Influence on functioning in daily life.

The aim of this study was to analyse the influence of stump skin problems on functioning in daily life in lower-limb amputees. A cross-sectional study was performed by means of a questionnaire containing 9 questions assessing functioning in daily life. Question scores were added to give a total score (range 0 (no influence) to 27 (maximum negative influence)). Two thousand and thirty-nine people were invited to participate, with 805 participants completing a questionnaire. Of these, 507 reported one or more skin problems. Skin problems had a negative influence on ability to perform household tasks, prosthesis use, social functioning, and participation in sports. The mean total score was 5.5 ± 4.1. This correlated significantly with the number of skin complaints (r = 0.483; p = 0.01). In linear regression analyses, gender (β = -0.15) and number of skin problems (β = 0.25) accounted for 23% of the total score. This study confirms the influence of skin problems on functioning in daily life.

Phantom Pain and Health-Related Quality of Life in Lower Limb Amputees

Amputation of a limb may affect quality of life. However, little is known concerning health-related quality of life in amputees. The purposes of this study were to describe health-related quality of life in a population of lower limb amputees and to investigate potential determinants, including phantom pain. Data from 437 patients with a lower limb amputation were analyzed in this cross-sectional study. Amputation-related problems were investigated using a questionnaire. Health-related quality of life was investigated using the RAND-36 DLV. Amputees with phantom pain had a poorer health-related quality of life than amputees without phantom pain. In general, the most important amputation-specific determinants of health-related quality of life were ‘walking distance’ and ‘stump pain.’