scholarly journals Factors associated with prosthesis embodiment and its importance for prosthetic satisfaction in lower limb amputees

2020 ◽  
Author(s):  
Robin Bekrater-Bodmann
Keyword(s):  
Lower Limb ◽  
Body Representation ◽  
Residual Limb ◽  
Present Sample ◽  
Visual Appearance ◽  
Factors Associated ◽  
Residual Limb Pain ◽  
The Trinity ◽  
Insufficient Knowledge ◽  
Lower Limb Amputees

Perceptual integration of a prosthesis into an amputee’s body representation, that is, prosthesis embodiment, has been proposed to be a major goal of prosthetic treatment, potentially contributing to the user’s satisfaction with the device. However, insufficient knowledge about individual or prosthetic factors predicting prosthesis embodiment challenges basic as well as rehabilitation research. In the present study, hierarchical multiple regression analyses on prosthesis embodiment – as assessed with the recently introduced Prosthesis Embodiment Scale – were applied to the survey data of 161 prosthesis-using lower limb amputees, entering relevant impartial (i.e., objective characteristics of the amputation or the prosthesis) and subjective-evaluative variables (i.e., the amputee’s perceptions related to the amputation or the prosthesis) as first- or second-level regressors, respectively. Significant regressors identified in these analyses together explained R2 = 36.5% of prosthesis embodiment variance in the present sample, with a lower level of amputation, less severe residual limb pain, more realistic visual appearance of the device, higher prosthetic mobility, and the absence of prosthesis-induced adverse stimulations of the residual limb representing significantly associated factors. Using the identical set of regressors hierarchically complemented by prosthesis embodiment on measures of prosthetic satisfaction – as assessed with the Trinity Amputation and Prosthesis Experience Scales – revealed that prosthesis embodiment significantly and positively predicted aesthetic as well as functional prosthesis satisfaction. These findings emphasize the importance of psychological factors for the integration of a prosthesis into the amputee’s body representation, which itself represents a crucial factor associated with prosthesis satisfaction. These results might have important implications for future prosthetic treatment. However, replication of the findings in an independent sample is required, as well as sophisticated experimental designs in order to elucidate the causality of effects.

scholarly journals Factors Associated With Prosthesis Embodiment and Its Importance for Prosthetic Satisfaction in Lower Limb Amputees

2021 ◽  
Vol 14 ◽  
Author(s):  
Robin Bekrater-Bodmann
Keyword(s):  
Lower Limb ◽  
Body Representation ◽  
Residual Limb ◽  
Present Sample ◽  
Visual Appearance ◽  
Factors Associated ◽  
Residual Limb Pain ◽  
Positive Valence ◽  
Insufficient Knowledge ◽  
Lower Limb Amputees

Perceptual integration of a prosthesis into an amputee's body representation, that is, prosthesis embodiment, has been proposed to be a major goal of prosthetic treatment, potentially contributing to the user's satisfaction with the device. However, insufficient knowledge about individual or prosthetic factors associated with prosthesis embodiment challenges basic as well as rehabilitation research. In the present study, hierarchical multiple regression analyses on prosthesis embodiment—as assessed with the recently introduced Prosthesis Embodiment Scale—were applied to the survey data of a large sample of prosthesis-using lower limb amputees, entering relevant objective-descriptive (i.e., unbiased characteristics of the amputation or the prosthesis) and subjective-evaluative variables (i.e., the amputee's perceptions related to the amputation or the prosthesis) as first- or second-level regressors, respectively. Significant regressors identified in these analyses together explained R2 = 36.3% of prosthesis embodiment variance in the present sample, with a lower level of amputation, less intense residual limb pain, more realistic visual appearance of the device, higher prosthetic mobility, and more positive valence of prosthesis-induced residual limb stimulations representing significantly associated factors. Using the identical set of regressors hierarchically complemented by prosthesis embodiment on measures of prosthetic satisfaction—as assessed with the Trinity Amputation and Prosthesis Experience Scales—revealed that prosthesis embodiment was significantly and positively associated with aesthetic as well as functional prosthesis satisfaction. These findings emphasize the importance of psychological factors for the integration of a prosthesis into the amputee's body representation, which itself represents a crucial factor associated with prosthesis satisfaction. The results might have important implications for future prosthetic treatment; however, replication of the findings in an independent sample is required, as well as sophisticated experimental designs in order to elucidate the causality of effects.

scholarly journals FACTORS ASSOCIATED WITH MOBILITY APPREHENSION IN AMPUTEES

2018 ◽  
Author(s):  
Shannon L Mathis
Keyword(s):  
Lower Limb ◽  
Pain Catastrophizing ◽  
Limb Amputation ◽  
Phantom Pain ◽  
National Assembly ◽  
Factors Associated ◽  
Avoidance Behaviors ◽  
Patient Will ◽  
Residual Limb Pain ◽  
Lower Limb Amputees

INTRODUCTION Studies report that after lower-limb amputation, patients have high levels of pain in the form of chronic low back pain, residual limb pain, and phantom pain leading to restrictions in functional activity1. Patients with high levels of pain and disability may develop avoidance behaviors. Vlaeyen et al. presents the fear-avoidance model, which suggests that after an injury there are two pathways a patient will take based on their interpretation of acute pain 2. Pain that is perceived as non-threatening leads to the patient’s recovery and return to normal activities of daily life. Pain that is perceived as threatening, or pain catastrophizing, causes anxiety and induces mobility apprehension which leads to avoidance behaviors. Avoidance behaviors may then lead to greater pain, depression, and disability3 . Factors described in the literature that are related to mobility apprehension were measured in a sample of lower limb amputees. The purpose was to determine which of pain intensity, interference, and catastrophizing lead to increased mobility apprehension. Abstract PDF  Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/32040/24454 How to cite: Mathis S.L. FACTORS ASSOCIATED WITH MOBILITY APPREHENSION IN AMPUTEES. CANADIAN PROSTHETICS & ORTHOTICS JOURNAL, VOLUME 1, ISSUE 2, 2018; ABSTRACT, ORAL PRESENTATION AT THE AOPA’S 101ST NATIONAL ASSEMBLY, SEPT. 26-29, VANCOUVER, CANADA, 2018. DOI: https://doi.org/10.33137/cpoj.v1i2.32040 Abstracts were Peer-reviewed by the American Orthotic Prosthetic Association (AOPA) 101st National Assembly Scientific Committee.  http://www.aopanet.org/  

Mobility, prosthesis use and health-related quality of life of bilateral lower limb amputees from the 2008 Sichuan earthquake

2018 ◽  
Vol 43 (1) ◽  
pp. 104-111 ◽  
Author(s):  
Wing Sum Li ◽  
Sze Ying Chan ◽  
Wai Wang Chau ◽  
Sheung-wai Law ◽  
Kai Ming Chan
Keyword(s):  
Quality Of Life ◽  
Lower Limb ◽  
Sichuan Earthquake ◽  
Factors Associated ◽  
Rehabilitation Outcomes ◽  
Related Quality ◽  
Health Related ◽  
Bilateral Lower Limb ◽  
Lower Limb Amputees

Background: The 2008 Sichuan Earthquake resulted in many amputees, yet due to the rare incidence, few studies have explored the rehabilitation outcomes and quality of life of bilateral lower limb amputees after major natural disasters. Objectives: To evaluate rehabilitation outcomes of 17 young and adult bilateral lower limb amputees under the StandTall rehabilitation programme and to identify factors associated with successful functional recovery of bilateral amputees after large-scale disasters. Study Design: Cross-sectional study. Methods: Mobility (amputee mobility predictor), prosthesis use (Houghton Scale) and health-related quality of life (Trinity Amputation and Prosthesis Experience Scale, Short Form 12) were evaluated through questionnaires and performance-based assessments. Means of scores were compared using T-tests. Results: Subjects with bilateral through-knee or transtibial amputations had less activity restriction ( p < 0.01) and higher mobility ( p = 0.03). Subjects using prostheses more than 50% waking time had better general adjustment ( p = 0.02) and less functional restriction ( p = 0.01). Exercise and education were associated with higher mobility ( p = 0.06) and mental quality of life, respectively ( p = 0.09). Conclusions: Amputation level and knee joint salvage, prosthesis use, exercise and education were associated with better rehabilitation outcomes including ambulation, adjustment and quality of life in bilateral lower limb amputees from the 2008 Sichuan Earthquake. Clinical relevance The study examined a unique group of traumatic bilateral lower limb amputees who were young and healthy before having traumatic amputations from a single episode of natural disaster. The factors associated with better functional recovery after the earthquake were investigated and may support future development of post-disaster rehabilitation strategies for bilateral lower limb amputees.

Reliability and construct validity of the Turkish version of the Trinity Amputation and Prosthetic Experience Scales (TAPES) in lower limb amputees

2011 ◽  
Vol 35 (2) ◽  
pp. 201-206 ◽  
Author(s):  
Semra Topuz ◽  
Özlem Ülger ◽  
Yavuz Yakut ◽  
Fatma Gül Şener
Keyword(s):  
Quality Of Life ◽  
Construct Validity ◽  
Lower Limb ◽  
Nottingham Health Profile ◽  
Measurement Tool ◽  
Turkish Version ◽  
Activity Restriction ◽  
The Trinity ◽  
Lower Limb Amputees

Background: In Turkey there is no amputee-specific instrument to measure health-related quality of life in lower limb amputees. Objectives: To evaluate the validity and reliability of a Turkish version of the Trinity Amputation and Prosthesis Experience Scales (TAPES). Study design: Outcome study to determine test–retest reliability and construct validity of the adapted Turkish version of the TAPES. Methods: After translation/retranslation of the TAPES, the Turkish version of the TAPES was applied to 47 amputees. A quality of life evaluation (Nottingham Health Profile), a satisfaction evaluation (Satisfaction with Prosthesis), and a functional assessment tool (Amputee Mobility Predictor) were also performed and analysed. Results: On the basis of retesting, the Turkish version of the TAPES was observed to be reliable. The first domain of the Turkish version, which includes psychosocial adjustment, activity restriction and satisfaction with the prosthesis, was found to be valid. However, the validity of the second domain could not be analysed. Conclusions: The Turkish version of the multidimensional TAPES survey is valid and reliable in Turkish unilateral lower limb amputees and may be used in clinical situations to assess the needs of amputees. Clinical relevance The Turkish version of the TAPES quality-of-life measurement tool for amputees is a valid instrument for assessing the effectiveness of rehabilitation and clinical applications.

Reliability and construct validity of a new Danish translation of the Prosthesis Evaluation Questionnaire in a population of Danish amputees

2016 ◽  
Vol 41 (5) ◽  
pp. 469-475 ◽  
Author(s):  
Jan Christensen ◽  
Patrick Doherty ◽  
Jakob Bue Bjorner ◽  
Henning Langberg
Keyword(s):  
Quality Of Life ◽  
Construct Validity ◽  
Lower Limb ◽  
Well Being ◽  
Residual Limb ◽  
Evaluation Questionnaire ◽  
Social Burden ◽  
Reliability Estimates ◽  
Lower Limb Amputees

Background:Most amputees live with their prostheses for a long time. Therefore, quality of life is an important outcome for lower limb amputees.Objective:To translate the Prosthesis Evaluation Questionnaire (PEQ) and evaluate psychometric properties.Study Design:Methodological research.Methods:Lower limb amputees responded to electronic versions of the PEQ and SF-36v2 at baseline (n=64), after two weeks (n=51), and after 12 weeks (n=50). Reliability was assessed using Cronbach’s alpha and intraclass correlation coefficient (ICC) analyses of the baseline and two weeks test-retest data. Estimates for standard error of measurement (SEM) were calculated based on reliability estimates. Construct validity was evaluated by testing using hypotheses testing.Results:Reliability estimates (ICC/Cronbach’s alpha) for the nine subscales were: Social Burden (0.85/0.76), Appearance (0.85/0.72), Residual Limb Health (0.80/0.69), Well-Being (0.78/0.90), Utility (0.76/0.89), Frustration (0.74/0.90), Perceived Response (0.62/0.80), Ambulation (0.61/0.94), Sounds (0.51/0.65). Construct validity was supported in three out of four subscales evaluated.Conclusions:The subscales Social Burden, Appearance, Well-Being, Utility and Frustration had consistent high reliability, supporting their use in assessing the prosthesis related quality of life in lower limb amputees. Results were mixed on three other scales (Residual Limb Health, Perceived Response, and Ambulation), while one scale, Sounds, had consistent low reliability.Clinical relevanceFor the first time a patient reported disease specific quality of life measure for lower limb amputees is available in Danish. Health care providers can now identify patients with reduced quality of life and measure treatment and rehabilitation effects over time.

scholarly journals Osteoporosis: A factor on residual limb pain in traumatic trans-tibial amputations

2008 ◽  
Vol 32 (2) ◽  
pp. 172-178 ◽  
Author(s):  
Kamil Yazicioglu ◽  
Ilknur Tugcu ◽  
Bilge Yilmaz ◽  
Ahmet Salim Goktepe ◽  
Haydar Mohur
Keyword(s):  
Bone Loss ◽  
Lower Limb ◽  
Gait Pattern ◽  
Residual Limb ◽  
Disuse Atrophy ◽  
Mineral Density ◽  
Limb Pain ◽  
Local Bone ◽  
Painful Sensation ◽  
Residual Limb Pain

Residual limb pain is defined as a painful sensation or feeling from the remaining part of the leg. Aggressive bone edge, bone spur formation, neuroma, abscess or bursitis are common causes of residual limb pain. On the other hand, regional osteoporosis on femur and tibia is an inevitable consequence in patients with lower limb amputations. The etiology of bone loss is uncertain but it is likely to be a local phenomenon in lower limb amputees. Altered gait pattern, decreased weight load, disuse atrophy and lack of muscular action at the limb seem to be important causal factors in the development of both local and generalized osteoporosis. The aims of this study are: (i) To determine if there is significant bone mineral density (BMD) difference at proximal tibias and femurs between intact and amputated limbs, (ii) to investigate the factors affecting bone loss in these areas and (iii) to investigate the possible relationship between residual limb pain and local bone loss. The 36 men who participated in this study had amputations due to land-mine injuries. Dual energy X-ray absorptiometry was used to determine BMD of the proximal femur and proximal tibia. The non-amputated limb was used as a control for the amputated side. BMD values on the amputated side were significantly lower than non-amputated side. In addition, BMD values on the amputated limbs with residual limb pain were significantly less than in those without residual limb pain. Insufficient mechanical loading leads to bone loss in patients with trans-tibial amputations. Furthermore, bone loss at tibia may be a cause of residual limb pain. However, this needs to be confirmed with more specific studies in the future.

How Common Are Chronic Residual Limb Pain, Phantom Pain, and Back Pain More Than 20 Years After Lower Limb Amputation for Malignant Tumors?

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Kevin Döring ◽  
Carmen Trost ◽  
Christoph Hofer ◽  
Martin Salzer ◽  
Tryphon Kelaridis ◽  
...  
Keyword(s):  
Back Pain ◽  
Lower Limb ◽  
Malignant Tumors ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Phantom Pain ◽  
Residual Limb ◽  
Limb Pain ◽  
Residual Limb Pain

Residual limb claudication after vascular transfemoral amputation

2017 ◽  
Vol 41 (6) ◽  
pp. 601-604 ◽  
Author(s):  
Riemke GA de Boer ◽  
Marieke A Paping ◽  
Bert Kap ◽  
Jan HB Geertzen
Keyword(s):  
Lower Limb ◽  
Developed Countries ◽  
Occlusive Disease ◽  
Limb Amputation ◽  
Residual Limb ◽  
Peripheral Artery ◽  
Transfemoral Amputation ◽  
Limb Pain ◽  
Peripheral Artery Occlusive Disease ◽  
Residual Limb Pain

Background:In all, 68% of all lower limb amputees experience residual limb pain. More than 95% of all lower limb amputations in developed countries are due to peripheral artery occlusive disease in combination with diabetes mellitus. Therefore, claudication, which is one of the most common manifestations of peripheral artery occlusive disease, should be taken into consideration in making a differential diagnosis of residual limb pain.Case description and methods:We present a case study of a 60-year-old diabetic patient who underwent a transfemoral amputation due to peripheral artery occlusive disease and who experiences residual limb pain. A computed tomography angiography was performed, and we searched for relevant literature on claudication pain after lower limb amputation.Conclusion:Little research has explored claudication as a cause of residual limb pain. More research will lead to a decrease in unnecessary prosthetic fittings and adjustments give more insight into the treatment and management of residual limb pain and prevent a decrease in mobility in amputees.Clinical relevanceClaudication due to peripheral artery occlusive disease should be included as a possible cause of residual limb pain to prevent unnecessary prosthetic fittings and adjustments and to minimize psychological effects and limitations in activities and participation.

scholarly journals Mind over matter: Perceived phantom/prosthesis co-location contributes to prosthesis embodiment in lower limb amputees

2021 ◽  
Author(s):  
Robin Bekrater-Bodmann
Keyword(s):  
Lower Limb ◽  
Body Representation ◽  
Phantom Limb ◽  
Negative Consequences ◽  
Cognitive Integration ◽  
Underlying Mechanisms ◽  
Phantom Limbs ◽  
The Relationship ◽  
Theoretical Considerations ◽  
Lower Limb Amputees

Prosthesis embodiment (PEmb) – the cognitive integration of a prosthesis into an amputees’ body representation – has been identified as key feature of prosthetic rehabilitation. However, the underlying mechanisms remain unclear. There is reason to assume that phantom limbs that are experienced as part of the bodily self (phantom self-consciousness, PSC) can affect PEmb, but only if the phantom and the prosthesis can be brought into perceived co-location (phantom prosthesis tolerance, PPT). In the present study, phantom-prosthesis interactions were examined in lower limb amputees, and a PPT component was psychometrically extracted. Mediation analysis revealed an indirect-only effect, where the relationship between PSC and PEmb was mediated by PPT, indicating that phantom limbs can transfer their immanent vividness to the artificial limb. Subsequent analyses suggested that this effect can compensate for negative consequences that arise from phantom limb awareness. These results shape theoretical considerations about the cognitive processes contributing to the bodily self.

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