Factors affecting quality of life in lower limb amputees

2011 ◽  
Vol 35 (1) ◽  
pp. 90-96 ◽  
Author(s):  
Richa Sinha ◽  
Wim JA van den Heuvel ◽  
Perianayagam Arokiasamy
Keyword(s):  
Quality Of Life ◽  
General Population ◽  
Lower Limb ◽  
Short Form ◽  
Treatment Protocol ◽  
Phantom Limb ◽  
Sf 36 ◽  
Prospective Longitudinal ◽  
Lower Limb Amputees

Background: Quality of life (QoL) is increasingly being recognized as an important outcome for rehabilitation programs, and has mainly been used to compare the efficacy of interventions or to compare amputees with other diseased populations. There is relatively a limited number of studies primarily focusing on analyzing the multitude of factors influencing QoL in amputees.Objectives: To identify important background and amputation related factors which affect quality of life (QoL) in lower limb amputees, and to compare QoL profile of amputees’ to that of general population.Study design: Cross-sectional.Methods: Lower limb amputees 18 years and above from a rehabilitation centre, a limb-fitting centre and four limb-fitting camps were interviewed ( n = 605). Structured questionnaires included patient background and amputation characteristics, and the MOS short-form health survey (SF-36) for assessing QoL. The SF-36 was administered to a general adult population using purposive sampling ( n = 184).Results: SF-36 PCS and MCS scores were found to be significantly lower for amputees when compared to those for the general population. In this study, employment status, use of an assistive device, use of a prosthesis, comorbidities, phantom-limb pain and residual stump pain were found to predict both PCS and MCS scores significantly, and explained 47.8% and 29.7% of variance respectively. Age and time since amputation accounted for an additional 3% of variance in PCS scores.Conclusions: The abovementioned factors should be addressed in order to ensure holistic reintegration and participation, and to enable the amputees to regain or maintain QoL. Prospective longitudinal studies are recommended to systematically study the change in QoL over time and to assess its determinants.Clinical relevanceProper appraisal of abovementioned factors in the rehabilitation programme would assist in establishing a treatment protocol, which would adequately address QoL in amputees.

scholarly journals Effects of phantom exercises on pain, mobility, and quality of life among lower limb amputees; a randomized controlled trial

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anna Zaheer ◽  
Arshad Nawaz Malik ◽  
Tahir Masood ◽  
Sahar Fatima
Keyword(s):  
Quality Of Life ◽  
Lower Limb ◽  
Controlled Trial ◽  
Phantom Limb ◽  
Mirror Therapy ◽  
Randomized Controlled ◽  
Sf 36 ◽  
Experimental Group ◽  
Lower Limb Amputees

Abstract Background The objective of the current study is to evaluate the effects of phantom exercises on phantom limb pain, mobility status, and quality of life in lower limb amputees treated with mirror therapy and routine physiotherapy. Methods It is a randomized controlled trial in which 24 unilateral lower limb amputees (above and below the knee) were randomly assigned to two equal groups i.e., control group (mirror therapy and conventional physical therapy) and experimental group in which, phantom exercises were given, additionally. Physical therapy included conventional therapeutic exercises while phantom exercises include imagining the movement of the phantom limb and attempting to execute these movements Data were collected at baseline, after 2 and 4 weeks of intervention using VAS (pain), AMP (mobility) and RAND SF-36 Version 1.0 (QOL) questionnaires. All statistical analyses were done with IBM SPSS 25.0 with 95% CI. Results Twenty-four amputees (17 males and 7 females) participated in this trial. The Mean age of the participants in experimental and control groups was 45.3 ± 11.1 years and 40.5 ± 12.5 years respectively. After the intervention, the pain (VAS score) was significantly lower in the experimental group (p = 0.003). Similarly, the experimental group demonstrated a significantly better score in the “bodily pain” domain of SF-36 (p = 0.012). Both groups significantly (p < 0.05) improved in other domains of SF-36 and ambulatory potential with no significant (p > 0.05) between-group differences. Conclusions The Addition of phantom exercises resulted in significantly better pain management in lower limb amputees treated with mirror therapy and routine physiotherapy. Trial registration This study is registered in the U.S National Library of Medicine. The clinical trials registration number for this study is NCT04285138 (ClinicalTrials.gov Identifier) (Date: 26/02/2020).

scholarly journals Correlation of ambulation potential with quality of life in lower limb amputees

2017 ◽  
Vol 4 (11) ◽  
pp. 4259 ◽  
Author(s):  
Mahima Agrawal ◽  
A. S. Kalra ◽  
Mrinal Joshi
Keyword(s):  
Quality Of Life ◽  
Negative Correlation ◽  
Lower Limb ◽  
Short Form ◽  
Research Centre ◽  
Short Form 36 ◽  
Capability Index ◽  
Sf 36 ◽  
Lower Limb Amputees

Background: To identify the effect of walking ability on quality of life in lower limb amputees and draw a correlation between prosthesis use, socio economic status and quality of life. It was an Observational Cross sectional study.Methods: Lower limb amputees excluding hip disarticulation and bilateral lower limb amputation, individuals above eighteen years of age who attended rehabilitation research centre outpatient door were interviewed. Structured questionnaire including patient background, amputation characteristics and details regarding prosthesis, was administered along with detailed musculoskeletal examination. Outcome variables: Locomotor capability index (LCI) and timed up and go test (TUG) were used for ambulation potential and Short form 36 (SF 36) for quality of life.Results: Significant correlation was observed between mental health short form 36 score and locomotor capability index (basic and advanced). Poor negative correlation of SF 36 score was observed with age (r=-0.125, p=0.006S). Significant correlation was observed between Physical Health Short Form 36 score and locomotor capability index (basic and advanced), and this correlation was higher and more significant. Poor negative correlation of SF 36 score was observed with age (r=-0.203, p<0.001S).Conclusions: Ability to ambulate is an independent factor that has a positive correlation with quality of life.

scholarly journals Time to debridement in open high-grade lower limb fractures and its effect on union and infections: A prospective study in a tropical setting

2020 ◽  
Vol 28 (1) ◽  
pp. 230949902090755
Author(s):  
Christina Marie Joseph ◽  
Thilak Samuel Jepegnanam ◽  
Boopalan Ramasamy ◽  
Vinoo Mathew Cherian ◽  
Manasseh Nithyananth ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lower Limb ◽  
Short Form ◽  
Care Center ◽  
Tertiary Care ◽  
High Grade ◽  
Lower Limb Fractures ◽  
Sf 36 ◽  
Limb Fractures

Purpose: To prospectively evaluate whether time to debridement has any correlation with union, infection, and quality of life in high-grade lower limb fractures in a tropical setting. Methods: A prospective cohort study was conducted at a tertiary care center in South India. Two hundred fifty-four adult skeletally mature patients with 301 grade 3 fractures involving the femur, tibia, or fibula were recruited. The cohort was empirically divided into two groups (early and late) based on the time to debridement (less than or more than 12 h from injury). Outcome: The primary outcome was nonunion. Secondary outcomes were deep infection rates and patients’ quality of life. Short form-36 (SF-36) and short musculoskeletal functional assessment (SMFA) questionnaires were also used. Patients were followed up for 9 months. Results: The follow-up rate was 93%. The late group had a significantly higher risk of nonunion (odds ratio(OR): 6.5, 95% confidence interval (CI): 2.82–14.95) and infections (OR: 6.05, 95% CI: 2.85–12.82). There was a 4% increase in the infection risk for each hour of delay for the initial 50 h ( p < 0.0001). SF-36 and SMFA scores were superior in the early group ( p < 0.0001). Conclusion: The study contradicts findings reported in the literature from the West. Our study was in agreement with our hypothesis and proved that debridement within 12 h resulted in significantly lower rates of nonunion and infections and an overall improved quality of life in high-grade open lower limb fractures in a developing country. Level of evidence: Level II Trial registration: German Clinical Trials Register DRKS00015186

Quality of Life in Patients with Systemic Sclerosis Compared to the General Population and Patients with Other Chronic Conditions

2009 ◽  
Vol 36 (4) ◽  
pp. 768-772 ◽  
Author(s):  
MARIE HUDSON ◽  
BRETT D. THOMBS ◽  
RUSSELL STEELE ◽  
PANTELIS PANOPALIS ◽  
EVAN NEWTON ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systemic Sclerosis ◽  
General Population ◽  
Chronic Diseases ◽  
Chronic Conditions ◽  
Short Form ◽  
Mental Component Summary Score ◽  
Population Norms ◽  
Sf 36

Objective.Systemic sclerosis (SSc) affects multiple physical, psychological, and social domains and is associated with impaired health-related quality of life (HRQOL).We compared the HRQOL of SSc patients with individuals in the general population and patients with other common chronic diseases.Methods.HRQOL of SSc patients in the Canadian Scleroderma Research Group registry was measured using version 2 of the Medical Outcomes Trust Short Form-36 (SF-36). Results were compared to US general population norms and scores reported for patients with other common chronic diseases, namely heart disease, lung disease, hypertension, diabetes, and depression.Results.SF-36 scores were available for 504 SSc patients (86% women, mean age 56 yrs, mean disease duration since onset of first non-Raynaud’s manifestation of SSc 11 yrs). The greatest impairment in SF-36 subscale scores appeared to be in the physical functioning, general health, and role physical domains. SF-36 subscale and summary scores in SSc were significantly worse compared to US general population norms for women of similar ages, except for mental health and mental component summary score, which were not significantly different, and were generally comparable to or worse than the scores of patients with other common chronic conditions.Conclusion.HRQOL of patients with SSc is significantly impaired compared to that of the general population and is comparable to or worse than that of patients with other common chronic conditions.

Factors influencing depression endpoints research (FINDER): Study design and population characteristics

2008 ◽  
Vol 23 (1) ◽  
pp. 57-65 ◽  
Author(s):  
Ana Garcia-Cebrian ◽  
Michael Bauer ◽  
Angel L. Montejo ◽  
Nicolas Dantchev ◽  
Koen Demyttenaere ◽  
...  
Keyword(s):  
Quality Of Life ◽  
General Population ◽  
Study Design ◽  
Short Form ◽  
Clinical Depression ◽  
Population Characteristics ◽  
Population Norms ◽  
Factors Influencing ◽  
Sf 36

AbstractFactors influencing outcomes of depression in clinical practice, especially health-related quality of life (HRQoL), are poorly understood. The Factors Influencing Depression Endpoints Research (FINDER) study is a European prospective, observational study designed to estimate the HRQoL of adults with a clinically diagnosed depressive episode at baseline, and 3 and 6 months after commencing antidepressant medication. We report here the study design and baseline patient characteristics.HRQoL was assessed by the 36-item Short-Form Health Survey (SF-36) and European Quality of Life-5 Dimensions (EQ-5D). Patient ratings on Hospital Anxiety and Depression Scale (HADS) and pain Visual Analogue Scale (VAS) were also obtained. Results (n = 3468) showed that SF-36 mental component summary (mean 22.2) was more than two SDs below general population norms (mean 50.0) and one SD below clinical depression norms (mean 34.8); the physical component summary (mean 46.1) was similar to general population (mean 50.0) and clinical depression norms (mean 45.0). Mean EQ-5D scores were also lower than general population norms. Mean HADS-Depression and -Anxiety subscores were 12.3 and 13.0, respectively. Fifty-six percent of patients reported an overall pain VAS score of at least 30 mm and 70% of these patients had no physical explanation for their pain.Further investigation into factors associated with HRQoL in depression after treatment initiation is warranted.

scholarly journals Penilaian Properti Psikometrik Instrumen Kualitas Hidup (HRQol) pada Populasi Umum: Tinjauan Sistematik

2019 ◽  
Vol 9 (2) ◽  
Author(s):  
Restu Nur Hasanah Haris ◽  
Rahmat Makmur ◽  
Tri Murti Andayani ◽  
Susi Ari Kristina
Keyword(s):  
Quality Of Life ◽  
General Population ◽  
Construct Validity ◽  
Psychometric Properties ◽  
Short Form ◽  
Internal Consistency Reliability ◽  
Ceiling Effect ◽  
Validity And Reliability ◽  
Sf 36

Quality of life (HRQoL) is a measure of a person's health in physical, spiritual, and emotional, and role functions in the society. Measurement of quality of life (HRQoL) is an important thing to understand and evaluate. Measurements are carried out not only on patients but also on the general population with the use of specific or generic instruments. The instrument used requires a psychometric properties test to ensure its validity and reliability. This article aims to conduct a systematic review of the psychometric properties of quality of life (HRQoL) instruments in the general population. Articles were collected in December 1st to 5th, 2018, from Pubmed and Google Scholar. The assessment was carried out using the checklist properties according to the cohen criteria and included the content validity, construct validity, internal consistency reliability, test-retest, ceiling effect and the level of credibility of the instruments. Among 80 articles obtained there were 24 articles that fulfilled the inclusion criteria. Short Form-36 (SF-36) instrument is the most widely used instrument in measuring the quality of life in the general population (26.6%). Some instruments have not been tested according to the criteria, while almost all instruments show a good level of validation of construct validity using convergent and discriminat validity with cronbach alpha values > 0.7. Test-retest reliability provides a good correlation. Some instruments show a ceiling effect. According to the assessment, the SF-36, SF-6D, EQ-5D, SF-12 and PedsQoL instruments are considered as established instruments. Further validation testing is needed to provide and support the measurement of subsequent quality of life (HRQoL) instruments.

Quality of life of cardiac patients eligible for implantation of cardiac pacemakers

2010 ◽  
Vol 4 (2) ◽  
pp. 647
Author(s):  
Izelina Helena de Freitas Antônio ◽  
Thatiara Lima Barroso ◽  
Agueda Maria Ruiz Zimmer Cavalcante ◽  
Luciano Ramos de Lima
Keyword(s):  
Social Sciences ◽  
Quality Of Life ◽  
Negative Impact ◽  
Short Form ◽  
Heart Diseases ◽  
Cardiac Patients ◽  
Calidad De Vida ◽  
Sf 36 ◽  
Prospective Longitudinal

ABSTRACTObjective: to determine the quality of life (QL) of cardiac patients eligible for implantation of a pacemaker (PM) in a cardiac hospital in the inland cities of Goiás States. Method: a cohort study, prospective, longitudinal quantitative approach. Purposeful sample applied to 25 patients who underwent implantation in the first half of 2009. The instrument used was the Short Form Healthy Survey (SF-36). The data were analyzed using Statistical Package for Social Sciences (SPSS) 15.0. The study was approved by the Ethics in Research of the University Center of Annapolis, protocol number 183/2008. Results: Chagas was the most frequent indication for implantation (68%), time of diagnosis of 1 to 25 years (56%), and 13 patients were undergoing treatment and 64% of patients with 1 insertion of pacemaker (PM), without changing so far. The major areas of life scores were Social Aspects (M=72,7), and the minor ones were Functional Capacity (M=31,6), demonstrating that QL is compromised because most of the areas did not exceed the average 50. There was no significance between age and QOL (p>0,05). Conclusion: we conclude that cardiac patients have significant negative impact on QL. Descriptors: quality of life; pacemaker, artificial; nursing; heart diseases; cardiac pacing, artificial; nursing assessment; chagas disease.    RESUMOObjetivo: determinar a qualidade de vida (QV) dos cardiopatas elegíveis à implantação de marca-passo (MP) em um hospital no interior de Goiás. Método: estudo de coorte, prospectivo, longitudinal, quantitativo. Amostra intencional aplicada a 25 pacientes submetidos ao implante de MP no primeiro semestre de 2009.  O instrumento utilizado foi o Short Form Healthy Survey (SF-36). Os dados foram analisados pelo Statistical Package for the Social Sciences (SPSS) 15.0. O estudo foi aprovado pelo Comitê de Ética em Pesquisa do Centro Universitário de Anápolis, com protocolo 183/2008. Resultados: Chagas foi a indicação mais frequente para implante (68%), com tempo de diagnóstico de 1 a 25 anos (56%), sendo que 13 pacientes realizavam tratamento e 64% dos pacientes com a 1ª inserção de MP. O domínio de maior escore para QV foi os Aspectos Sociais (M=72,7) e menor Capacidade Funcional (M=31,6), demonstrando que a QV é comprometida já que a maioria dos domínios não ultrapassou a média 50. Não houve significância entre idade e QV (p>0,05). Conclusão: os cardiopatas apresentam importante impacto negativo na QV. Descritores: qualidade de vida; marca-passo artificial ; enfermagem; cardiopatias; estimulação cardíaca artificial; avaliação em enfermagem; doença de chagas.    RESUMEN Objetivo: determinar la calidad de vida (CV) de los pacientes cardiacos elegibles para la implantación de un marcapasos (PM) en un hospital cardíaco del interior de Goiás. Método: estudio de cohorte, prospectivo, longitudinal de enfoque cuantitativo. Con propósito de la muestra aplicada a 25 pacientes que se sometieron a la implantación en el primer semestre de 2009. El instrumento utilizado fue la Encuesta Healthy Short Form (SF-36). Los datos fueron analizados mediante el Statistical Package for Social Sciences (SPSS) 15,0. El estudio fue aprobado por la Ética en la Investigación del Centro Universitario de Anápolis, con el protocolo 183/2008. Resultados: Chagas fue la indicación más frecuente para implante (68%), el tiempo de diagnóstico de 1 a 25 años (56%), y 13 pacientes fueron sometidos a tratamiento y el 64% de los pacientes con la inserción de 1 MP, ningún cambio en la tiempo. La principale área de cuentas de la vida fue los aspectos sociales (M=72,7), y los menores fueron la capacidad funcional (M = 31,6). No hubo significación entre la edad y la calidad de vida (CV) (p>0,05). Conclusión: se concluye que los pacientes cardíacos tienen un impacto negativo significativo en la CV. Descriptores: calidad de vida; marcapaso artificial; enfermería; cardiopatías; estimulación cardíaca artificial; evaluación en enfermería; enfermedad de chagas.   

scholarly journals Do Patients Profit from Third Time CABG?

2009 ◽  
Vol 2 ◽  
pp. OJCS.S2277
Author(s):  
Malakh Shrestha ◽  
Hassina Baraki ◽  
Nawid Khaladj ◽  
Nurbur Koigeldiyev ◽  
Axel Haverich ◽  
...  
Keyword(s):  
Quality Of Life ◽  
General Population ◽  
Operative Mortality ◽  
Short Form ◽  
Single Centre ◽  
Heart Insufficiency ◽  
Sf 36 ◽  
Acceptable Quality

Introduction It has been shown that in experienced hands repeated CABG is doable procedure. However the quality of life after third time CABG has not been evaluated so far. Patients and Methods The peri-operative data of 25 (22 male, mean age of 65.5 ± 8.0 years) consecutive patients in a single centre undergoing third time-CABG from 4/96 to 11/06 were studied. Quality of life (QoL) was assessed by Short Form (SF)-36 Questionnaire. Results 30 day mortality was 12% (3/25). Seven died during follow-up. In 15 survivors median follow-up was 94 months (2–122 months). 1-, 5-, and 10-year survival were 77.8%, 65.0%, and 53.1%, respectively. Present NYHA status was significantly improved in comparison to preoperative values (2.4 ± 0.8 vs. 3.2 ± 0.56, p = 0.012). QoL was comparable with an age matched general population with heart insufficiency. Conclusion Third time CABG can be performed with acceptable peri-operative mortality. Significant improvement of NYHA status and acceptable quality of life results justifies our surgical approach in this challenging patient cohort.

Quality Of Life In CML Patients: Better Outcomes Associated With TKI Interruption

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 4004-4004
Author(s):  
Stephane Giraudier ◽  
Etienne Audureau ◽  
Kahina Oukerfellah ◽  
Michel Tulliez
Keyword(s):  
Quality Of Life ◽  
General Population ◽  
Short Form ◽  
Univariate Analysis ◽  
Response To Therapy ◽  
Molecular Response ◽  
Younger Age ◽  
Sf 36 ◽  
Mental Hrqol

Abstract Background Recent data indicate that the survival of chronic myeloid leukemia (CML) patients, who are in Major Molecular Response with TKI, is not statistically significantly different from that of the general population and that a subgroup of patients who experienced long-term Complete Molecular Responses can stop therapy without relapse. However, less is known regarding the actual impact of TKI therapies or their cessation on patients’ health-related quality of life (HRQoL). Aim We conducted a monocentric observational quality of life study on CML patients having received or currently receiving Imatinib, Nilotinb or Dasatinib, in order to investigate the relationships between HRQoL and treatment or treatment interruption. Patients and Methods The analysis was performed on 110 CML patients diagnosed and recruited from 1999 to 2012 in our department and followed for more than 3 months. At the time of HRQoL assessment (median duration from diagnosis: 5.6 years; interquartile range [IQR] 2.4-10.1), 8.8% of patients had stopped TKI therapy for more than 3 months because of long-time CMR, 49.6% were treated with Imatinib, 22.1% with Dasatinib and 19.5% with Nilotinib. The total number of different prescribed TKIs in the course of the disease was 1 in 60.2% of the cases, 2 in 23% and 3 in 16.8%. HRQoL was assessed with the 36-Item Short-Form Health Survey (SF-36), using age-sex adjusted standardized scores expressed as standard deviation [SD] from the French general population reference values for age and gender. Key socio-demographic and clinical data including age, gender, education, Sokal risk, response to therapy and duration of treatment, smoking, obesity, hypertension, diabetes, dyslipidemia, number of medications, ECOG performance status, ADL/IADL and Mini Nutritional Assessment scale (MNA) were also taken into account. Univariate and multivariate linear regression analyses were used to identify independent predictors for each SF-36 subscale and summary scores (Physical [PCS] and Mental Composite Scores [MCS]). Results In univariate analysis, factors significantly associated with lower PCS scores included younger age (under 45) (-1.20 SD), lower education level (-0.79SD), obesity (BMI>30) (-1.39SD), pre-existence of dyslipidemia (-1.57SD), ADL with more than 1 limitation (-0.98SD), ECOG >1 (-1.83SD), MNA at risk or poor nutritional status (-1.26SD); factors associated with lower MCS scores were pre-existence of dyslipidemia (-0.92SD), ECOG>1 (-1.31SD), MNA (-0.87SD), current CML treatment (-0.28SD [Imatinib],-0.42SD [Sprycel] and -0.53SD [Nilotinib]) and more than 2 lines of TKI (-0.89SD). In multivariate analysis, only younger age (p=0.009) and dyslipidemia (p=0.023) were negatively correlated to PCS and current CML treatment (p=0.001) and more than 2 TKI (p=0.013) negatively correlated to MCS. In figure 1, we report the standardized SF-36 scores of CML patients according to age (1a), treatment (1b) or treatment lines (1c). Conclusion We confirm previous data indicating worse HRQoL in younger CML patients treated with Imatinib. In our study, this effect was also observed with 2nd-generation TKIs. Our findings were in the same order of magnitude as previously reported (Efficace et al, blood, 2011). We failed to demonstrate any major differential effect between the different TKI (Imatinib, Nilotinib or Dasatinib) on HRQoL suggesting that the choice of TKI therapy cannot be determined by this criterion. Moreover, comparing the number of TKI changes, we failed to demonstrate any effect of “only-one” change of TKI on HRQoL,. This suggests that one change in CML therapy does not worsen QOL , whereas a drastic decrease in mental HRQoL scores was found in patients receiving more than two lines of TKI. The most relevant finding was that patients who benefited from TKI interruption because of stable complete molecular remission had better mental HRQoL outcomes, suggesting that TKI interruption could have a positive impact on HRQoL and hence has to become the objective to achieve in CML to normalize HRQoL. Disclosures: Giraudier: NOvartis: Consultancy, Honoraria, Membership on an entity’s Board of Directors or advisory committees, Research Funding; BMS: Consultancy, Honoraria. Tulliez:Novartis: Consultancy, Honoraria.

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