Health related quality of life in patients with dysvascular transtibial amputation

Abstract

Sixty adults with transtibial amputations completed a validated outcomes instrument assessing their prosthesis related quality of life. All had their amputations because of peripheral vascular disease or nonsalvageable diabetic foot infection. Of the patients, 46 were male and 14 were female. Forty-four had diabetes. All of the subjects used a prosthesis for a minimum of 6 months. The Prosthetic Evaluation Questionnaire measured prosthesis function (usefulness, residual limb health, and appearance), mobility (ambulation and transfers), psychosocial response (perceived responses, frustration, and social burden), well-being, and satisfaction. Scoring was accomplished using a linear analog scale, with poor responses rated as 0 and excellent responses rated as 100. Mobility scores were the lowest (ambulation, 55.3; transfer, 64.6). Functional scores were slightly better (usefulness, 65.7; residual limb health, 79.7; and appearance, 73.3). Psychosocial response scored best (perceived responses, 86.6; frustration, 69.1; and social burden, 66.4). The overall well-being scale graded at 67.0, and overall satisfaction scored at 65.2. Although experts in rehabilitation would expect function and mobility scores to be highest and psychosocial scores to be lowest, this population actually perceived the reverse to be true. These data provide realistic expectations for patients faced with transtibial amputation and a benchmark to measure newer treatment modalities or technical innovations.