Health-related profiles of people with lower limb loss

Abstract

Objectives: To construct profiles of self-reported health indicators to examine differences and similarities between people with lower limb loss and a normative sample (hereafter called the norm) and to compare health indicators between subgroups based on level and etiology of limb loss.

Design: Survey.

Setting: General community.

Participants: Adults with unilateral lower limb loss (N=1091) participated in this study. Eligibility criteria included lower limb loss due to trauma or dysvascular complications and regular use of a prosthesis.

Interventions: Not applicable.

Main outcome measures: The Patient-Reported Outcomes Measurement Information System 29-item Health Profile version 1.0 measures physical function, pain interference, fatigue, sleep disturbance, anxiety, depression, and satisfaction with participation in social roles. The norm includes 5239 individuals representative of the U.S. general population in sex, age, race, ethnicity, and education.

Results: People with lower limb loss reported statistically significantly worse physical function, pain interference, and satisfaction with participation in social roles and significantly less fatigue than did the norm. People with transfemoral (ie, above-knee) amputation significantly differed in physical function from people with transtibial (ie, below-knee) amputation. Similarly, people with amputation due to trauma and dysvascular etiology significantly differed in physical function and satisfaction with social roles after adjusting for relevant clinical characteristics.

Conclusions: People with lower limb loss generally report worse physical function, pain interference, and satisfaction with social roles than do the norm. People with dysvascular amputation reported worse physical function and satisfaction with social roles than did people with traumatic amputation. Health indicator profiles are an efficient way of providing clinically meaningful information about numerous aspects of self-reported health in people with lower limb loss.

Keywords: Amputation; Artificial limbs; Limb prosthesis; Outcome assessment (health care); Quality of life; Rehabilitation.

Conflict of interest statement

Conflicts of interest: The authors report no conflicts of interest. They do acknowledge funding for this research through the National Institute of Child Health and Human Development (as stated above).

Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Figures

Fig. 1

PROMIS Profile-29 scores for the overall sample of people with LLL (N=1091). The bars represent the mean score in each domain. Scores above 50 indicate that the sample of people with LLL had more of the measured construct (e.g., anxiety, sleep disturbance) and scores below 50 indicate that the sample of people with LLL had less of the measured construct. 50 represents the mean of the large samples representative of the US general population, except for sleep disturbance where 50 represents a mean of a large sample that includes a slightly higher proportion of less healthy people than the general population.

Fig. 2

PROMIS Profile-29 scores for subgroups based on etiology and level of amputation. Bars represent the mean score in each domain. Scores above 50 indicate that the sample of people with LLL had more of the measured construct (e.g., anxiety, sleep disturbance) and scores below 50 indicate that the sample of people with LLL had less of the measured construct.