What is the Quality of Life of Transtibial Amputees in Brunei Darussalam?

Abstract

Introduction: Lower limb amputations have a profound impact on the quality of life (QoL) of the patients. This study was done to assess the QoL of patients with transtibial (below-the-knee) amputations (TTA) and transtibial amputees fitted with prosthesis. Material and Methods: A case-control study of patients who had undergone TTA from 2015 to 2018 was conducted in Raja Isteri Pengiran Anak Saleha Hospital (RIPAS). Complete data was available for 30 subjects and it was compared with 30 diabetic, non-amputee patients matched for age and gender. QoL was assessed using the RAND 36-Item Health Survey (SF-36) and the functional outcome of prosthesis-fitted transtibial amputees was assessed using the Houghton Scale. Results: Almost all cases of TTA were a result of vascular problems related to diabetes and chronic renal disease (n=29; 97%). Eighteen (60%) participants were fitted with prosthesis and 15 (50%) reported having phantom pain. QoL of participants was found to be significantly lower than that of age and sex-matched diabetic non-amputees with regards to physical functioning, role limitation due to physical health, emotional well-being, social functioning, and bodily pain. The mean Houghton Score for participants fitted with prosthesis was 4.89 (SD= 2.83) suggesting low functional outcome. Conclusion: TTA has a negative impact on the QoL of patients, especially in terms of functionality. The availability of prosthesis does not significantly improve the quality of life except in the physical functioning domain. Emotional well-being should be emphasised more in the rehabilitation process as this study found poor emotional well-being among participants.

Quality of life, body image and self-esteem in patients with unilateral transtibial amputations

“…QoL is recognised as a major predictor of rehabilitation programmes and has mainly been used to evaluate the effectiveness of these programmes, or to compare people with amputations with diseased or normal population 16 , 17 . There is extensive literature on the different factors that influence QoL in people living with amputations.…”

Comparing quality of life in lower extremity tumor patients undergoing limb salvage surgery and amputation: a meta-analysis

“…QOL meaning involves evaluating one’s overall life satisfaction with how they are currently operating in comparison to what they consider to be their ideal normal ( 31 ). QOL is acknowledged as a significant indicator of rehabilitation programs and has been primarily used to assess the efficacy of these programs or to compare individuals with amputations with the ill or healthy community ( 17 , 32 ). The subscales, which reflect changes in physical health in the bone tumor patients, show that QOL values decline in individuals even with other different musculoskeletal disorders ( 33 ).…”