This cross-sectional descriptive study was initiated to investigate the relationship between physical activity and perceived quality of life in a lower-limb amputee population. The objective was to show which aspects of physical activity were most strongly linked to quality-of-life factors in this special patient group. The outcome measurements were two questionnaires: a section of the Trinity Amputation and Prosthetic Experience Scales (TAPES) and the World Health Organization Quality-of-Life Scale (WHOQOL-Bref). The former measures activity restriction and has Athletic, Functional, and Social subscales. The latter includes Physical, Psychological, Social, and Environmental domains, and measures the individual's perception of their quality of life. The two questionnaires were sent by post to 75 male and female participants with either trans-tibial or trans-femoral amputation who were receiving prosthetic care from a Glasgow-based rehabilitation and mobility centre and who met the inclusion criteria. All participants were over 18 years of age (mean age 66 years). In total, 25 participants returned the questionnaires-a response rate of 33%. According to analysis, 8 of the 12 relationships found were statistically significant. There was a very strong correlation between scores on the social elements of each questionnaire. The correlations between scores on the functional and athletic elements of the TAPES questionnaire and scores on the social element of the WHOQOL-Bref questionnaire were less strong. Our findings support the need for greater acknowledgement by healthcare professionals involved in the care of those with amputation about the importance of the patient's social relationships with friends and family. Education about the importance of increasing and maintaining a level of physical activity conducive to health benefits should be implemented within a supportive sociable environment for the patient with lower-limb amputation.

Background: The UK will host the Paralympics in 2012 and the Commonwealth Games in 2014 showcasing the talents of elite athletes and aiming to inspire the population to become involved. However, low levels of physical activity are prevalent: only 40% of men and 28% of women meet the minimum UK physical activity recommendations. The population of people with limb absence is no exception. Objectives: To determine if people with amputation are participating in physical activity and sport; whether post-amputation activity levels match pre-amputation levels; and if there are motivations and barriers to participation. Study Design: Literature review. Methods: Five reviewers systematically searched all peer reviewed and gray literature in seven bibliographic databases and the Cochrane Library. Results: Following rigorous elimination, 12 articles were finally included in the review and critically appraised. Four themes were identified: components; rehabilitation outcomes; body image; and motivations and barriers to participation. Conclusion: People with limb absence are not participating in physical activity conducive to health benefits, and only a minority participate in exercise and sports. Participation following amputation does not mirror that of pre-amputation levels, and more barriers than motivations exist to adopting or maintaining a physically active lifestyle. Clinical relevance This literature review aims to inform those involved in rehabilitation and ongoing care of those with limb absence about what motivates or precludes their participation in physical activity, exercise and sport. Such knowledge could be applied to improving health and wellbeing in this population.

Background: Physical activity is a positive component of human health. Its effects are associated with improvement in physical, psychological and social aspects of quality of life. Physical activity is therefore an important factor in the rehabilitation of amputees. Objective: To analyse the relationship between physical activity and quality of life for amputees in southern Brazil. Study Design: Descriptive, cross-sectional design with nonrandomized sample. Methods: A total of 40 questionnaire instruments were distributed to subjects who met the inclusion criteria, with a response rate of 55% (22 individuals, n = 15 males, n = 7 females). Outcome measurements were obtained through the International Physical Activity Questionnaire and World Health Organization Quality of Life-Bref. Results: The sample was characterized by physically active adult male prosthetic users with positive quality of life, and amputation below the right knee caused by mechanical trauma related to traffic accidents with motorcycles. Significant correlations were identified between all domains of quality of life and between level of physical activity and psychological quality of life. No correlation was identified between gender and quality of life variables or physical activity levels. Conclusions: This study showed that in very active amputees of both genders, level of physical activity is not associated with quality of life except for the psychological domain. Clinical relevanceThis paper contributes to understanding of the importance of physical activity for the quality of life of amputees, principally of active individuals with lower limb amputations. It provides evidence for the relevance of physical mobility in the process amputee rehabilitation, mainly for psychological domain of quality of life.

Background: The Trinity Amputation and Prosthesis Experience Scales—Revised assesses adjustment to amputation and to using a prosthesis and considers psychosocial adjustment, activity restriction, satisfaction with the prosthesis, and other aspects related to health and physical activities, including residual and phantom limb pain. Objectives: The aim of this study was to assess the semantic equivalence of the Trinity Amputation and Prosthesis Experience Scales—Revised when translated into Brazilian Portuguese. Study design: Qualitative study. Methods: The process was conducted in five stages: translation of the questionnaire into Brazilian Portuguese; development of a first consensual version in Brazilian Portuguese; appraisal of the translation by an expert committee; back-translation; and semantics assessment of the instrument. For semantic evaluation, the translated and adapted Brazilian Portuguese versions were applied to a convenience sample of 10 individuals. Results: The translated instrument showed a high degree of comprehension within the target population, as it was observed all questions from Part I and II were score 4 or higher on an Ordinal Scale ranging from 0 to 5. Conclusion: The Brazilian version of Trinity Amputation and Prosthesis Experience Scales—Revised has a satisfactory verbal comprehension and is now ready for assessment of its psychometric properties. Clinical relevance The process of semantic evaluation of the Brazilian version of the Trinity Amputation and Prosthesis Experience Scales—Revised makes available to health professionals and researchers who work with people with amputations initial information on cross-cultural adaptation and degree of comprehension of this scale.

Background: Reduced function and health in individuals with lower limb amputation is well documented. Step count measurement could facilitate rehabilitation and help monitor functional health outcomes. Objectives: To determine whether mean daily step count changed between in-patient rehabilitation and consecutive leave periods. Study Design: Observational study. Methods: Nine individuals with bilateral traumatic amputations attending rehabilitation at the Defence Medical Rehabilitation Centre during a 4-month period were invited to participate in the study (two bilateral transfemoral, two bilateral transfemoral/knee disarticulation, two transfemoral/transtibial, one bilateral transfemoral plus transradial, one bilateral transfemoral plus transhumeral and one transfemoral/transtibial/transradial). Prostheses worn by each participant were fitted with an activity monitor (LAM2TM; PAL Technologies Ltd, Glasgow). Mean daily step count was analysed for each participant following 2 weeks in-patient rehabilitation and consecutive 2 weeks away from rehabilitation. Results: Nine participants completed the study (time since injury: 19 ± 7 months, age: 26 ± 6 years). Mean daily step count significantly decreased from 2258 ± 192 during in-patient rehabilitation to 1387 ± 363 at home ( p < 0.01). Conclusion: The step count decreased when away from rehabilitation, confirming the hypothesis that the mean daily step count would change between in-patient rehabilitation and consecutive leave period. Clinical relevance These data provide an indication of the step count achievable by young, military male personnel with bilateral lower limb amputations and highlights differences between intensive in-patient rehabilitation and consecutive leave periods. It is suggested that further investigation and support of clinical monitoring could facilitate rehabilitation tailored to the individual.