Limb Deficiency and Prosthetic Management. 4. Comorbidities Associated With Limb Loss

Ethics in Rehabilitation: Access to Prosthetics and Quality Care Following Amputation

“…The perceived loss of ability to engage in previous vocational, avocational, social, sexual, and leisure activities can play a greater role in postamputation quality of life than the absence of the limb itself [16]. Body image, self-esteem, and quality of life can be significantly negatively influenced by amputation [17], and health survey scores are often far lower for patients who have had lower limb amputations than for control subjects.…”

Impact of Limb Loss in the United States

“…A psychological consultation before amputation is appropriate, because patients who are unprepared and depressed may experience more physical and psychosocial difficulties afterward. 41 Functional outcome can be improved by appropriately addressing the psychosocial factors, because loss of the ability to relate psychologically, vocationally, avocationally, sexually, and socially after amputation may have more impact on quality of life than the loss of the limb itself. 41 The impact of limb loss extends beyond chronic conditions and mortality rates and deeply penetrates the emotional and psychological well-being of patients.…”

“…41 Functional outcome can be improved by appropriately addressing the psychosocial factors, because loss of the ability to relate psychologically, vocationally, avocationally, sexually, and socially after amputation may have more impact on quality of life than the loss of the limb itself. 41 The impact of limb loss extends beyond chronic conditions and mortality rates and deeply penetrates the emotional and psychological well-being of patients. Amputation should be regarded as a therapeutic and reconstructive procedure that is designed to restore function and attempt to allow the patient to return to an independent lifestyle.…”

“…People with limb loss perceive that they are participating less in recreational activities, are more dissatisfied at work, and are more impaired in community mobility relative to their premorbid status. 41 If they are part of a coordinated rehabilitation program available across the continuum, reintegration into the community can be initiated early with the supervision of the team members during such activities as organized trips for shopping, recreation reintroduction, and initiating return to work or school as tolerated. Persons who lose a limb perceive barriers in many domains of social life, especially with encountering difficulties returning to work.…”

“…46 Ultimate adjustment to amputation and perceived quality of life are influenced by multiple factors, such as patient's age, level of maturity, past experiences, temperament, inner strength, personality traits, coping strategies, social support, comorbidities, site and cause of amputation, length of time since amputation, and comprehensiveness of care. 41 Caring for the adjustment of the person after limb loss needs to be individualized and extend beyond becoming mobile with a prosthetic. Losing a limb has a significant impact on the social lives of patients with limb loss.…”