Patient satisfaction following lower-limb amputation: the role of gait deviation

Background: Patient satisfaction is an important measurement in healthcare for administrators, clinicians and patients. Objectives: This study investigated the role of gait deviation in patient satisfaction following lower-limb amputation and prosthesis prescription. Study design: A cross-sectional study was done. Methods: Twenty community-based unilateral lower-limb amputees, 12 transtibial and 8 transfemoral, were recruited from support groups. Participants completed the prosthesis evaluation questionnaire (PEQ) with embedded satisfaction-related questions, the timed-up-and-go test and the six-minute walk test, and also underwent quantitative three-dimensional analysis. Kinematic deviation was summarized using the gait profile score (GPS). Results: Satisfaction levels were generally high (median 80 + /100). Sociodemographic variables did not correlate significantly with any of the satisfaction measures (−0.35 ≤ r ≤ 0.54). Satisfaction correlated strongly with the PEQ scales, particularly ambulation, prosthetic utility, frustration, perceived response and social burden (r ≥ 0.70). By contrast, the relationships between satisfaction and performance-based outcome measures were not significant (−0.45 ≤ r ≤ 0.43), and the GPS did not correlate with any satisfaction measures (−0.23 ≤ r ≤ 0.15). Conclusions: In this study of high functioning amputees, gait deviation was unimportant to the amputee, while self-reported functional ability and attitudes toward the prosthesis were the strongest correlates of satisfaction following lower-limb amputation. Clinical relevance For the high functioning individuals with lower-limb amputation in this study, gait deviation was not a significant correlate of patient satisfaction. Results suggest that improving self-perceived functional ability and attitudes toward the prosthesis, rather than minimizing gait deviation, will improve patient satisfaction.

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