Measuring Community Integration in Persons With Limb Trauma and Amputation: A Systematic Review

Resnik, Linda; Borgia, Matthew; Silver, Benjamin

doi:10.1016/j.apmr.2016.08.463

Cited by 25 publications

(12 citation statements)

References 164 publications

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“…Questions from the Trinity Amputation and Prosthesis Experience Scale - Revised (TAPES-R) [46, 47] and the Disabilities of the Arm, Shoulder, and Hand (DASH) [45, 47, 48] were included within the survey to obtain information related to functional level, device utilization, and device satisfaction. The amputee group completed all questions from the TAPES- R that were relevant to upper-limb amputees, with wording adjusted to focus answers on experience with a prosthetic device as opposed to experience with an amputation.…”

Section: Methodsmentioning

confidence: 99%

Amputee, clinician, and regulator perspectives on current and prospective upper extremity prosthetic technologies

Rekant

Fisher

Boninger

et al. 2020

Preprint

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Existing prosthetic technologies for people with upper limb amputation are being adopted at moderate rates and unfortunately these devices are often abandoned. The aims of this study were to: 1) understand the current state of satisfaction with upper extremity prostheses, 2) solicit feedback about prosthetic technology and important device design criteria from amputees, clinicians, and device regulators, and 3) compare and contrast these perspectives to identify common or divergent priorities. Twenty-one adults with upper limb loss, 35 clinicians, and 3 regulators completed a survey on existing prosthetic technologies and a conceptual sensorimotor prosthesis driven by implanted myoelectric electrodes with sensory feedback provided via stimulation of dorsal root ganglion. User and clinician ratings of satisfaction with existing prosthetic devices were similar. While amputees, clinicians, and regulators were similarly accepting of technology in general, amputees were most accepting of the proposed implantable sensorimotor prosthesis. Overall, stakeholders valued user-centred outcomes such as individualized task goals, improved quality of life, device reliability, and user safety; a large emphasis was put on these last two outcomes by regulators. The results of this study provide insight into the priorities of amputees, clinicians, and regulators that will inform future upper-limb prosthetic design and clinical trial protocol development.

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Section: Methodsmentioning

confidence: 99%

Amputee, clinician, and regulator perspectives on current and prospective upper extremity prosthetic technologies

Rekant

Fisher

Boninger

et al. 2020

Preprint

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“…We made this choice based not only on the survey's reliability in this population 17 but also its usefulness in capturing community integration at the participation level under the International Classification of Functioning, Disability and Health (ICF) framework. 19 Under the ICF framework, successful participation in personal, family, community, and societal roles can be viewed as the highest level of functional recovery from disabilityinducing conditions. This approach has been recognized as essential in assessing rehabilitation outcome after amputation.…”

Section: Discussionmentioning

confidence: 99%

“…This measure was selected for its short time requirement to complete and established reliability in the limb loss population. 17,18 Specifically, the "Role-Emotional," "Role-Physical," and "Social Functioning" subscales were recommended by Resnik et al 19 as valid and reliable instruments for measuring community integration in persons with limb loss. Each participant's personal financial status was assessed using the question: "Do you (ever) have difficulty making ends meet at the end of the month?"…”

Section: Methodsmentioning

confidence: 99%

Financial difficulty in community-dwelling persons with lower limb loss is associated with reduced self-perceived health and wellbeing

Lee

Chien

Chin

et al. 2020

Prosthetics &Amp; Orthotics International

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Background: Socioeconomic status has been shown to be an important factor in the disparate prevalence and selected treatment of limb loss, but how personal financial difficulty affects patients’ health outcomes is currently unclear. Objective: Examining how presence and experience of personal financial difficulty affects perceived health and wellbeing in individuals with lower limb loss. Study Design: Cross-sectional study. Methods: A total of 90 participants (68 males, mean age 58.7 ± 16.7 years) were recruited from local physical therapy and prosthetic and orthotic clinics, rehabilitation hospitals, and a regional amputee patient support group. All participants were community-dwelling, non-military adults with amputation involving at least one major lower limb joint. Participants were interviewed, and each completed a survey that included basic demographic/medical information, self-reported health and wellbeing (Short-Form Health Survey, SF-36v2), and a question to determine their financial situation after limb loss. Multiple regression analyses were used to examine the effect of financial difficulty on the eight subscales of SF-36v2 while accounting for age, gender, and amputation level. Results: Experiencing financial difficulty significantly and negatively affected Role-Physical and Role-Emotional subscale scores ( p < 0.01 and p = 0.02, respectively). Individuals with financial difficulty scored approximately 60% lower in these two specific subscales. Conclusion: Experiencing financial difficulty is a significant predictor for diminished work or daily activity participation due to physical and emotional stresses. Clinicians and health policy makers need to understand how socioeconomic factors may prevent individuals with lower limb loss from achieving higher levels of functional recovery and community re-integration after amputation. Clinical relevance Our findings showed that presence or experience of financial difficulty was significantly associated with diminished community re-integration in community-dwelling, non-military adults with lower limb loss. It affects both physical and emotional aspects of wellbeing. Clinicians should be aware how socioeconomic factors may affect social re-integration after amputation.

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“…The primary outcome, disability, was measured using the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0). The WHODAS 2.0 is recommended for use with people after LLA, is internally consistent (Cronbach alpha = 0.75‐0.87), and assesses disability due to any health condition 24‐26 . Items on the WHODAS 2.0 ask participants to indicate the amount of difficulty experienced when completing 12 common tasks over the past 30 days, where 1 indicates no difficulty and 5 indicates extreme difficulty 27 .…”

Section: Methodsmentioning

confidence: 99%

“…The WHODAS 2.0 is recommended for use with people after LLA, is internally consistent (Cronbach alpha = 0.75-0.87), and assesses disability due to any health condition. [24][25][26] Items on the WHODAS 2.0 ask participants to indicate the amount of difficulty experienced when completing 12 common tasks over the past 30 days, where 1 indicates no difficulty and 5 indicates extreme difficulty. 27 A sum score was used in this analysis, where higher WHODAS 2.0 scores indicate greater severity of disability.…”

Section: Outcome Measuresmentioning

confidence: 99%

Self‐Efficacy and Social Support are Associated with Disability for Ambulatory Prosthesis Users After Lower‐Limb Amputation

Miller

Cook

Magnusson

et al. 2020

PM&R

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Background Interventions targeting psychosocial factors may improve rehabilitation outcomes for prosthesis users after lower‐limb amputation (LLA), but there is a need to identify targeted factors for minimizing disability. Objective To identify psychosocial factors related to disability for prosthesis users after LLA in middle age or later. Design Cross‐sectional study. Setting General community. Participants Participants with LLA (N = 122) were included in this cross‐sectional study if their most recent LLA was at least 1 year prior, they were ambulating independently with a prosthesis, and they were between 45 and 88 years old. Interventions Not applicable. Main Outcome Measures Disability, the primary outcome, was measured using the World Health Organization Disability Assessment Schedule 2.0 (WHODAS). Candidate psychosocial variables included self‐efficacy, social support, and motivation, measured using the Self‐Efficacy of Managing Chronic Disease questionnaire (SEMCD), Multidimensional Scale of Perceived Social Support questionnaire (MSPSS), and modified contemplation ladder (mCL), respectively. The hypothesis was that greater self‐efficacy, social support, and motivation would be associated with lower disability when controlling for covariates. Results The covariate model, including etiology, age, sex, U.S. military veteran status, LLA characteristics, time since LLA, medical complexity, and perceived functional capacity, explained 66.1% of disability variability (WHODAS 2.0). Backward elimination of candidate psychosocial variables stopped after removal of motivation (P = .10), with self‐efficacy (P < .001) and social support (P = .002) variables remaining in the final model. The final model fit was statistically improved (P < .001) and explained an additional 6.1% of disability variability when compared to the covariate model. Conclusions Greater self‐efficacy and social support are related to lower disability after LLA. Findings suggest there may be a role for interventions targeting increased physical function, self‐efficacy, and social support for ambulatory prosthesis users after LLA in middle age or later, especially when complicated by multiple chronic conditions.

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Measuring Community Integration in Persons With Limb Trauma and Amputation: A Systematic Review

Cited by 25 publications

References 164 publications

Amputee, clinician, and regulator perspectives on current and prospective upper extremity prosthetic technologies

Amputee, clinician, and regulator perspectives on current and prospective upper extremity prosthetic technologies

Financial difficulty in community-dwelling persons with lower limb loss is associated with reduced self-perceived health and wellbeing

Self‐Efficacy and Social Support are Associated with Disability for Ambulatory Prosthesis Users After Lower‐Limb Amputation

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