scholarly journals Disability, economic and work-role status of individuals and their families in Bangladesh, post-unilateral lower-limb amputation (LLA) and pre-rehabilitation: a cross-sectional study

2021 ◽  
Author(s):  
Md Shapin Ibne Sayeed ◽  
Jodi Oakman ◽  
Michael P. Dillon ◽  
Rwth Stuckey
Keyword(s):  
Lower Limb ◽  
Rural Areas ◽  
Cross Sectional Study ◽  
Lower Limb Amputation ◽  
World Health ◽  
Limb Amputation ◽  
Mobility Impairment ◽  
Cross Sectional ◽  
Gendered Roles ◽  
The Impact

Abstract Background To quantify disability, occupation and socioeconomic status of individuals and their families in Bangladesh, post-unilateral lower-limb amputation (LLA) and pre-rehabilitation. Methods Between November 2017 and February 2018, people with unilateral LLA attending two XXX prosthetic rehabilitation centres were surveyed prior to rehabilitation, using the World Health Organization Disability Assessment Schedule (WHODAS-2.0) with additional socio-economic questions. Data was analysed descriptively, and cross-tabulation conducted with Chi-square test and Fisher’s exact tests. Results Seventy-six individuals participated. The majority had transtibial amputation (61.8%) from trauma (64.5%), were young adults (37.92 ± 12.35 years), in paid work prior to LLA (80%), married (63.2%), male (81.6%), from rural areas (78.9%), with primary/no education (72.4%). After LLA, mobility (WHODAS score 74.61 ± 13.19) was the most negatively affected domain. Most (60.5%) participants did not return to a paid or unpaid occupation. Acute healthcare costs negatively impacted most families (89.5%), and over 80% became impoverished. Nearly 70% of previous income-earners became economically dependent resulting in changes to traditional family roles. Conclusions Following LLA, most participants experienced significant mobility impairment, were unable to return to paid occupation and became economically dependent. The study population presents with many different characteristics from other people with LLA globally, which suggest with timely rehabilitation a return to paid employment is possible. The impact of LLA extends beyond the individual, including to families, many of whom face challenges with changes to traditional primary earner gendered roles. Improved access to timely and affordable rehabilitation is required to reduce the significant personal and societal costs of disability after LLA.

Prostheses Use and Satisfaction among People with Lower-limb Amputation in 10 districts of Bhutan

2019 ◽  
Vol 5 (2) ◽  
pp. 21-27
Author(s):  
Ugyen Norbu ◽  
Tandin Zangpo ◽  
Jit Bahadur Darnal ◽  
Hari Prasad Pokhrel ◽  
Roma Karki
Keyword(s):  
Service Delivery ◽  
Lower Limb ◽  
Cross Sectional Study ◽  
Functional Mobility ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Cross Sectional ◽  
Face To Face ◽  
Level Of Satisfaction ◽  
Lower Limb Prostheses

Introduction: The use of lower-limb prostheses restores functional mobility and improves quality of life for people with lower limb amputation. However, the use of prostheses is significantly impacted by users’ satisfaction with their prostheses and service delivery. Therefore, the excellence of prosthetic rehabilitation is not only assessed by the number of prostheses users but is also determined by the level of satisfaction with the prostheses and services received. The study was conducted to determine prostheses use and satisfaction among people with lower-limb amputation. Methods: A cross-sectional study was conducted among lower-limb prosthetic users in 10 districts of Bhutan. Data was collected by face-to-face interview using the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST) questionnaire. Participants were recruited by purposive sampling. Results: The study found that 96.4% of persons with lower-limb amputation currently used prostheses and 79% of them have used it for more than 7 hours/day. However, 44% of prostheses needed repair. The total QUEST score of satisfaction was 4.0 (SD 0.5). Conclusion: Majority of lower-limb prostheses are in use and the users reported being quite satisfied with their prostheses and service delivery. The study recommends initiating follow-up services to improve prosthetic use and overall satisfaction scores for both prostheses and service delivery.

Prevalence and Factors Associated with Lower Limb Amputation in Patients Hospitalized for Diabetic Foot: a Cross-sectional Study

2020 ◽  
Vol 16 ◽  
Author(s):  
Abdourahmane Ndong ◽  
Jacques Noel Tendeng ◽  
Mohamed Lamine Diao ◽  
Diatou Gueye Dia ◽  
Amadou Diop Dia ◽  
...  
Keyword(s):  
Lower Limb ◽  
Univariate Analysis ◽  
Cross Sectional Study ◽  
Male Gender ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated ◽  
Stage D

Background: Diabetes is the leading cause of non-traumatic amputation of the lower limb. Several factors associated with amputation are described in the literature, but they remain not well studied in our context. Objectives: Our aim is to determine the prevalence and factors associated with amputation in patients hospitalized for diabetic foot. Methods: This is a prospective cross-sectional study performed over the period from December 1, 2017 to June 30, 2018. The patients included were those hospitalized for trophic disorders of the foot in patients with type 2 diabetes. The studied parameters were: epidemiological, diagnostic, therapeutic and evolutionary data. An univariate analysis and then a binary logistic regression identified the factors associated with lower limb amputation. Results: We included 53 patients. A lower limb amputation was performed in 8 patients (prevalence of 15.1%). Univariate analysis found as factors associated with major amputation: advanced age (p = 0.031); male gender (p = 0.003); use of traditional treatment (p = 0.036); non-compliance with the diabetic diet (p = 0.016); stage D of the University of Texas (UT) Classification (p = 0.029); grade ≥ 2 of the UT Classification (p = 0.002). Logistic regression finds only the following two variables as independent factor associated with amputation: male gender (p = 0.004, OR = 36.1 and CI = 3.2-402.9); stage D of the UT classification (p = 0.014, OR = 21.3 and CI = 1.8-244.2). Conclusion: Controlling these factors would allow better management of diabetes to avoid complications.

scholarly journals Long-term symptoms and function after war-related lower limb amputation: A national cross-sectional study

2018 ◽  
Vol 52 (5) ◽  
pp. 348-351 ◽  
Author(s):  
Elham Esfandiari ◽  
Amir Yavari ◽  
Amir Karimi ◽  
Mehdi Masoumi ◽  
Mohammadreza Soroush ◽  
...  
Keyword(s):  
Lower Limb ◽  
Cross Sectional Study ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Sectional Study ◽  
Cross Sectional ◽  
And Function

scholarly journals The impact of coronavirus outbreak on breastfeeding guidelines among Brazilian hospitals and maternity services: a cross-sectional study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Walusa Assad Gonçalves-Ferri ◽  
◽  
Fábia Martins Pereira-Cellini ◽  
Kelly Coca ◽  
Davi Casale Aragon ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
World Health ◽  
Breastfeeding Support ◽  
Cross Sectional ◽  
Maternity Services ◽  
Community Needs ◽  
Care Services ◽  
Skin Contact ◽  
Health Organization ◽  
The Impact

Abstract Background The World Health Organization recognizes exclusive breastfeeding a safe source of nutrition available for children in most humanitarian emergencies, as in the current pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Despite the Brazilian national guideline protecting breastfeeding practices, there are many concerns about protecting infants from their infected mothers. This study aimed to analyze how the Brazilian hospitals and maternity services promote and support mothers suspected or diagnosed with coronavirus disease (COVID-19). Methods This is a descriptive cross-sectional and multicenter study which collected data from 24 Brazilian hospitals and maternity services between March and July 2020. Representatives of the institutions completed a questionnaire based on acts to promote and support breastfeeding, the Baby-Friendly Hospital Initiative, and Brazil’s federal law recommendations. Results The results showed that in delivery rooms, 98.5% of the services prohibited immediate and uninterrupted skin-to-skin contact between mothers and their infants and did not support mothers to initiate breastfeeding in the first hour. On the postnatal ward, 98.5% of the services allowed breastfeeding while implementing respiratory hygiene practices to prevent transmission of COVID-19. Companions for mothers were forbidden in 83.3% of the hospitals. Hospital discharge was mostly between 24 and 28 h (79.1%); discharge guidelines were not individualized. Additionally, a lack of support was noticed from the home environment’s health community network (83.3%). Hospital and home breast pumping were allowed (87.5%), but breast milk donation was not accepted (95.8%). There was a lack of guidance regarding the use of infant comforting strategies. Guidelines specific for vulnerable populations were not covered in the material evaluated. Conclusions In Brazil, hospitals have not followed recommendations to protect, promote, and support breastfeeding during the COVID-19 outbreak. The disagreement between international guidelines has been a major issue. The absence of recommendations on breastfeeding support during the pandemic led to difficulties in developing standards among hospitals in different regions of Brazil and other countries worldwide. The scientific community needs to discuss how to improve maternal and infant care services to protect breastfeeding in the current pandemic.

scholarly journals Obesity and Skin Problems in Persons With a Lower Limb Amputation: An Observational Study

2021 ◽  
Author(s):  
Terezka S. Mollee ◽  
Pieter U. Dijkstra ◽  
Rienk Dekker ◽  
Jan H.B. Geertzen
Keyword(s):  
Body Mass Index ◽  
Body Weight ◽  
Confidence Interval ◽  
Body Mass ◽  
Lower Limb ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Residual Limb ◽  
Prevalence Of Obesity ◽  
The Impact

Abstract Background: A lower limb amputation can lead to weight gain and obesity. However, data regarding the prevalence of obesity in the Dutch population with a lower limb amputation are lacking. Furthermore, the impact of obesity on skin problems of the residual limb and the need of prosthetic repairs is unknown. The aim of this study was to determine the prevalence of obesity in Dutch persons with a lower limb amputation and to investigate the relationship between body weight, body mass index and skin problems of the residual limb and the frequency of prosthetic repairs. Methods: A survey was performed among adults with a unilateral lower limb amputation due to any cause, and who are user of a prosthesis. The survey consisted of measurement of the subjects’ body height and weight, a questionnaire which assessed self-reported skin problems in the previous month and factors potentially associated with these skin problems, and assessment of the frequency of visits to the orthopedic workshop. Results: In total, 413 persons were enrolled. Of them, 39% (95% confidence interval 35%−44%) was overweight and 28% (95% confidence interval 24%−33%) was obese. A total of 77% (95% confidence interval 73%−81%) reported one or more skin problems in the past month. Body weight and body mass index were neither associated with the presence of skin problems in general nor with the number of prosthetic repairs. Persons with severe skin problems had a slightly lower body mass index (26.6 kg/m2 vs. 28.0 kg/m2, p = 0.012). Persons with skin problems were younger than those without (difference in means 6.0 years (95% confidence interval 3.0−8.9)). Conclusion: Our findings show that obesity is common in the ambulant population with a lower limb amputation, with a prevalence being higher than in the general Dutch adult population. However, its negative impact on the presence of skin problems and the frequency of prosthetic repairs may be limited.

scholarly journals Barriers and facilitators to utilisation of rehabilitation services amongst persons with lower-limb amputations in a rural community in South Africa

2018 ◽  
Vol 43 (1) ◽  
pp. 95-103 ◽  
Author(s):  
Ugendrie Naidoo ◽  
Liezel Ennion
Keyword(s):  
South Africa ◽  
Lower Limb ◽  
Rural Areas ◽  
Lower Limb Amputation ◽  
Barriers And Facilitators ◽  
Rural Setting ◽  
Limb Amputation ◽  
Rehabilitation Services ◽  
Personal Factors ◽  
Persons With Disabilities

Background: Persons with disabilities who reside in rural areas experience challenges accessing and utilising health services and rehabilitation. Due to the high prevalence of diabetes mellitus in rural regions, the risk of having a lower-limb amputation is increasing. Comprehensive rehabilitation is vital to mitigate the negative impact that a lower-limb amputation has on a person. Objective: To explore the barriers and facilitators to accessing rehabilitation experienced by persons with lower-limb amputations in a rural setting. Study Design: A qualitative descriptive approach was used to collect and analyse data. Methods: Data were collected from 11 conveniently sampled participants from three sub-district hospitals in the rural iLembe district, Kwa-Zulu Natal, South Africa. Data were collected using semi-structured interviews to explore the barriers and facilitators perceived by persons with lower-limb amputations in a rural region. Results: The three main barriers identified in this study were environmental factors, financial constraints and impairments. These barriers negatively impacted the participant’s utilisation of rehabilitation. The two main facilitators identified were environmental facilitators and personal factors which aided participant’s utilisation of rehabilitation. Conclusion: Access to rehabilitation was mainly hindered by the challenges utilising transport to the hospital, while self-motivation to improve was the strongest facilitator to utilising rehabilitation. Clinical relevance Rehabilitation is essential in preparation for prosthetic fitting. If a person cannot access rehabilitation services, they will remain dependent on caregivers. Highlighting the challenges to utilisation of rehabilitation in rural areas can assist to reduce these barriers and improve the functional status of persons with lower-limb amputations.

Factors associated with mobility apprehension in persons with lower limb amputation

2020 ◽  
Vol 44 (4) ◽  
pp. 208-214
Author(s):  
Shannon L Mathis
Keyword(s):  
Standard Deviation ◽  
Lower Limb ◽  
Avoidance Behavior ◽  
Pain Catastrophizing ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Walking Ability ◽  
Factors Associated ◽  
The Mean ◽  
The Impact

Background: Factors that are related to mobility apprehension were measured in a sample of persons with lower-limb amputation. Objectives: The purpose was to determine whether intensity, interference, or catastrophizing are associated with mobility apprehension. Study design: Cross-sectional study. Methods: Persons with amputation of a lower limb who were attending a national limb loss conference were recruited to complete a survey. Subjects were administered the Tampa Scale for Kinesiophobia to measure mobility apprehension. The Brief Pain Inventory was administered to quantify the affect of pain on general activity, walking ability, and enjoyment of life. The Pain Catastrophizing Scale was administered to assess the tendency to ruminate and magnify pain sensations. A multivariable linear regression was performed to determine factors associated with mobility apprehension. Results: Fifty-three people with lower-limb amputation participated in the study. The mean (standard deviation) score for mobility apprehension was 34.2 (6.0). Mean (standard deviation) pain intensity and interference scores were 1.6 (1.7) and 2.5 (2.6), respectively. The mean (standard deviation) pain catastrophizing score was 9.1 (10). Pain catastrophizing was the only variable associated with higher mobility apprehension ( β = 0.31, p < 0.001, R2 = 0.32). Results suggest that for every one-point increase in the pain catastrophizing score, mobility apprehension will increase by 0.3 of a point. Conclusion: These preliminary results suggest that pain catastrophizing was related to mobility apprehension in this cohort of persons with lower-limb amputation. This relationship indicates that the exploration of avoidance behaviors, such as pain catastrophizing, may be useful when developing a program for physical rehabilitation. Clinical relevance Pain catastrophizing, an avoidance behavior, may be associated with higher levels of mobility apprehension in persons with major lower-limb amputation. Understanding the impact of fear-avoidance behavior will allow clinicians to identify individuals at risk for poor outcomes following amputation surgery and to develop psychological strategies to complement treatment.

scholarly journals Participation restrictions and vocational rehabilitation needs experienced by persons with a unilateral lower limb amputation in the Western Cape, South Africa

2019 ◽  
Vol 8 ◽  
Author(s):  
Tak Wing Yu ◽  
Liezel Ennion
Keyword(s):  
South Africa ◽  
Vocational Rehabilitation ◽  
Lower Limb ◽  
Lower Limb Amputation ◽  
World Health ◽  
Limb Amputation ◽  
Western Cape ◽  
Participation Restrictions ◽  
Health Organization ◽  
Rehabilitation Needs

Background: Vocational rehabilitation (VR) aims to rehabilitate a person with an amputation back into actively participating in society. Even though lower limb amputation (LLA) surgery is commonly performed in South Africa (SA), little research has been published on the participation restrictions experienced by and vocational needs of persons with LLA in the Western Cape (WC).Objectives: The aim of this study was to determine and explore the participation restrictions and VR needs of persons with a unilateral LLA in the WC.Method: A mixed-methods approach and a sequential exploratory design were utilised to collect data from 50 persons with an LLA. Participants were conveniently sampled within the Cape Metropole region of the WC, SA. The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) tool was used to collect the quantitative data, and telephonic interviews were conducted for qualitative data collection.Results: A third (28%) of participants in this study were unemployed, and only 14% (n = 7) of the participants owned or used a prosthesis. In addition, 50% of the participants either had a disability grant or were on pension. The participation restrictions identified were mainly related to mobility where 74% (n = 37) of participants had extreme difficulty with mobility in general, 92% (n = 46) struggled with walking distances longer than 1 km and 80% (n = 40) had extreme difficulty in completing household tasks quickly. The main VR needs identified in this study were the inadequate rehabilitation services that target ambulation (standing and walking) to facilitate employment.Conclusion: Persons with a unilateral LLA still experience significant difficulties in mobility 3 months post-amputation, which negatively affects their participation in society and vocational activities.

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