Consequences of non-vascular trans-femoral amputation: A survey of quality of life, prosthetic use and problems

Individuals with unilateral trans-femoral amputations due to non-vascular causes were studied in a mailed survey designed to investigate health-related quality of life (HRQL), prosthetic use and problems. The Swedish SF-36 Health Survey and a structured questionnaire designed for trans-femoral amputees were used. The series consisted of 97 subjects (60 men, 37 women), aged 20 to 69 years with a mean of 22 years since the amputation. Trauma was the cause of amputation in 55%, tumour in 35% and other causes in 10%. Ninety-two (92) subjects (95%) had a prosthesis and 80 (82%) used it daily. General HRQL was significantly lower than Swedish age- and gender-matched norms in all dimensions as measured by SF-36. Most frequently reported problems that had led to reduction in quality of life were heat/sweating in the prosthetic socket (72%), sores/skin irritation from the socket (62%), inability to walk in woods and fields (61%) and inability to walk quickly (59%). Close to half were troubled by stump pain (51%), phantom limb pain (48%), back pain (47%) and pain in the other leg (46%). One fourth considered themselves to have a poor or extremely poor overall situation. Trans-femoral amputation, due to non-vascular causes, has an evident impact on quality of life and there are considerable problems related to the amputation and the prosthesis. Efforts to improve the physical and the psychological well-being for this group, with a long life expectancy, are needed.

[1]  R. Waters,et al.  Energy cost of walking of amputees: the influence of level of amputation. , 1976, The Journal of bone and joint surgery. American volume.

[2]  E M Burgess,et al.  Functional capabilities of lower extremity amputees. , 1978, Archives of physical medicine and rehabilitation.

[3]  C. T. Huang,et al.  Amputation: energy cost of ambulation. , 1979, Archives of physical medicine and rehabilitation.

[4]  S. Wonderlich,et al.  Depression among amputees. , 1983, The Journal of clinical psychiatry.

[5]  G R Fernie,et al.  Extent of artificial limb use following rehabilitation , 1987, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[6]  H. Alaranta,et al.  Lower limb amputations in Southern Finland 1984-1985 , 1988, Prosthetics and orthotics international.

[7]  Factors That Influence the Level of Activities in Persons with Lower Extremity Amputation , 1990, Rehabilitation nursing : the official journal of the Association of Rehabilitation Nurses.

[8]  Mb Lerner-Frankiel.  Functional community ambulation : what are your criteria? , 1990 .

[9]  C. C. Nielsen,et al.  A Survey of Amputees: Functional Level and Life Satisfaction, Information Needs, and the Prosthetist??s Role , 1991 .

[10]  C. Sherbourne,et al.  The MOS 36-Item Short-Form Health Survey (SF-36) , 1992 .

[11]  R. Schulz,et al.  Social discomfort and depression in a sample of adults with leg amputations. , 1992, Archives of physical medicine and rehabilitation.

[12]  B. Persson,et al.  Amputation for occlusive arterial disease. A prospective multicentre study of 177 amputees. , 1992, International orthopaedics.

[13]  L. Ebskov.  Level of lower limb amputation in relation to etiology: An epidemiological study , 1992, Prosthetics and orthotics international.

[14]  C. Roberts,et al.  A review of the energy expenditure of disabled locomotion with special reference to lower limb amputees , 1992 .

[15]  W. Eisma,et al.  Walking speed of normal subjects and amputees: Aspects of validity of gait analysis , 1993, Prosthetics and orthotics international.

[16]  A. Jette.  Using health-related quality of life measures in physical therapy outcomes research. , 1993, Physical therapy.

[17]  J. Pell,et al.  Quality of life following lower limb amputation for peripheral arterial disease. , 1993, European journal of vascular surgery.

[18]  A. Hof,et al.  The relationship between comfortable and most metabolically efficient walking speed in persons with unilateral above-knee amputation. , 1993, Archives of physical medicine and rehabilitation.

[19]  Problems Experienced and Perceived by Prosthetic Patients , 1993 .

[20]  A M Boonstra,et al.  The gait of unilateral transfemoral amputees. , 1994, Scandinavian journal of rehabilitation medicine.

[21]  R. Ingram,et al.  Lower limb amputation following injury: a survey of long-term functional outcome. , 1994, Injury.

[22]  H. J. de Jongh,et al.  Prosthetic gait of unilateral transfemoral amputees: a kinematic study. , 1995, Archives of physical medicine and rehabilitation.

[23]  P. Good,et al.  Permutation Tests: A Practical Guide to Resampling Methods for Testing Hypotheses , 1995 .

[24]  G. Reiber,et al.  Prosthetic history, prosthetic charges, and functional outcome of the isolated, traumatic below-knee amputee. , 1995, The Journal of trauma.

[25]  B. Kopjar,et al.  The SF-36 health survey: a valid measure of changes in health status after injury. , 1996, Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention.

[26]  L. Ebskov.  Relative mortality in lower limb amputees with diabetes mellitus , 1996, Prosthetics and orthotics international.

[27]  E. Isakov,et al.  Mobility of persons after traumatic lower limb amputation. , 1997, Disability and rehabilitation.

[28]  J. Larson.  The MOS 36-Item Short form Health Survey , 1997, Evaluation & the health professions.

[29]  H. Alaranta,et al.  Ten-year survival of Finnish lower limb amputees , 1998, Prosthetics and orthotics international.

[30]  N. Westgren,et al.  Quality of life and traumatic spinal cord injury. , 1998, Archives of physical medicine and rehabilitation.

[31]  Diane Potvin,et al.  Predisposing Factors Related to Prosthetic Use by People with a Transtibial and Transfemoral Amputation , 1998 .

[32]  J. Flory,et al.  What are quality of life measurements measuring? , 1998, BMJ.

[33]  B. Ebskov.  Relative mortality and long term survival for the non-diabetic lower limb amputee with vascular insufficiency , 1999, Prosthetics and orthotics international.

[34]  D. Potvin,et al.  Enabling factors related to prosthetic use by people with transtibial and transfemoral amputation. , 1999, Archives of physical medicine and rehabilitation.

[35]  D A Boone,et al.  Phantom limb, residual limb, and back pain after lower extremity amputations. , 1999, Clinical orthopaedics and related research.

[36]  M. Legro,et al.  Issues of importance reported by persons with lower limb amputations and prostheses. , 1999, Journal of rehabilitation research and development.

[37]  D. Hart.  Orthotics and Prosthetics National Office Outcomes Tool (opot): Initial Reliability and Validity Assessment for Lower Extremity Prosthetics , 1999 .

[38]  J. Czerniecki,et al.  Chronic phantom sensations, phantom pain, residual limb pain, and other regional pain after lower limb amputation. , 2000, Archives of physical medicine and rehabilitation.

[39]  E J MacKenzie,et al.  Rehabilitation and the long-term outcomes of persons with trauma-related amputations. , 2000, Archives of physical medicine and rehabilitation.