Prevalence of physical health comorbidities and long-term functional outcomes among community-reintegrated veterans following lower limb amputation in Sri Lanka

Abstract

IntroductionLower limb amputation (LLA) poses significant health challenges, including physical health comorbidities (PHCs) and functional limitations. Military veterans, who typically undergo traumatic LLA at a young age, endure these challenges for an extended period. Understanding the extent of these challenges is vital to designing tailored and feasible postamputation care for them. In this study, we evaluated the prevalence of PHCs and long-term functional outcomes among community-reintegrated veterans following LLA in Sri Lanka.MethodsA comparative cross-sectional study was conducted in five districts in Sri Lanka. Prevalence of PHCs and functional outcomes were compared between community-reintegrated veterans with war-related traumatic LLA and a matched able-bodied cohort. Data on PHCs were collected from participants’ medical records and through a self-administered questionnaire. Timed-Up-and-Go (TUG) and 2 min walk test (2MWT) were used to compare functional outcomes between the groups. Veterans’ functional level was identified using the K-level classification.ResultsVeterans were active prosthetic users who had undergone LLA >10 years ago. Sixty-six (77.6%) veterans reported experiencing phantom limb pain. A significantly higher prevalence of diabetes mellitus (34.2%), hypertension (22.4%), knee osteoarthritis (18.8%), knee pain (20%) and back pain (69.4%) was observed among veterans compared with the able-bodied group (p<0.05). Veterans demonstrated significantly lower levels of functional mobility (2MWT: mean (SD): 113.6 (14.8); increased risk of falling (TUG): mean (SD): 10.6 (1.8)) compared with able-bodied individuals (150.8 (11.9) and 7.2 (0.9), respectively, p<0.001). The majority of the veterans belonged to the K3 functional level (71.8%).ConclusionsThe higher prevalence of PHCs and impaired functional outcomes underscores the multifaceted health challenges faced by veterans with LLA living in low-resource community settings with limited access to rehabilitation. These findings provide insights into the unique rehabilitation needs of individuals with similar backgrounds, informing the design and implementation of tailored rehabilitation interventions.

Quality of Life, Physical Activity Participation, and Perceptions of Physical Rehabilitation Among Community-Reintegrated Veterans With Lower Limb Amputation in Sri Lanka: Convergent Parallel Mixed Methods Study

“…A high prevalence of amputation-associated comorbidities was found among the veterans. These data have been published separately [ 49 ].…”

“…This study revealed lower QoL outcomes among veterans compared with the findings in a previous study conducted over 20 years ago on the same population [ 25 ]. This suggests a decline in QoL over time, possibly attributed to reduced PA participation and rising comorbidities associated with a sedentary lifestyle and poorly managed pain and discomfort [ 49 ]. Veterans perceived a decline in their ability to engage in PA and associated it with aging and comorbidities, such as back pain, knee joint pain, hypertension, and diabetes.…”