Psychosocial and physical adjustments and prosthesis satisfaction in amputees: a systematic review of observational studies

Abstract

Background: Adjustment to amputation is a complex process because it encompasses physical and psychosocial aspects as well as satisfaction with the artificial limb.Purpose: To review the scientific production on psychosocial and physical adjustments to amputation and prosthesis use as well as prosthetic satisfaction in people with lower limb amputation in the last 10 years.Methods: This review was conducted on the MEDLINE via Pubmed, Web of Science and Scopus databases. Original and observational studies published in the last 10 years were included, with topics related to adjustment to amputation and prosthesis use as well as prosthetic satisfaction in people with lower limb amputations.Results: A total of 1042 articles were identified in the initial search, but after analysing the criteria 16 articles were used for analysis in their entirety. Regarding psychosocial adjustments, higher rates of depression, anxiety and body image disorders were observed among people with amputations. Phantom and residual limb pain, gender, employment status and daily hours of prosthesis use may influence psychosocial adjustment. Physical adjustment may be influenced by the level of amputation, educational background, age, daily prosthesis use, ambulatory assistive devices and presence of comorbidities. The areas of greatest prosthetic dissatisfaction were colour and weight.Conclusion: Considering that most of the studies related to the satisfaction and adjustment of the prosthesis are cross-sectional studies, longitudinal studies should be conducted, since monitoring individuals over the years and verifying how these variables change over time may contribute to obtaining more data on the factors that influence prosthetic fitting and satisfaction.Implications for rehabilitationAdjustment to amputation and prosthesis use involves both physical and psychosocial issues, it is important that besides physical rehabilitation, psychological interventions and education and communication activities between the patient and the health professionals are carried out.The adaptation to the prosthesis and the recovery of walking capacity are important goals in the rehabilitation process and the knowledge of the physical and psychosocial factors associated with amputation and the use of the prosthesis can help the health team to provide better care to these subjects.Well-adjusted, comfortable and easy-to-use prostheses are of great importance as they enable the patient to perform their daily activities and maintain their independence.It is important to encourage the participation of the individual in both rehabilitation and choice of prosthesis.

Keywords: Amputation; artificial limbs; patient satisfaction; psychosocial impact; review.