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Critical Reviews™ in Physical and Rehabilitation Medicine
SJR: 0.117 SNIP: 0.228 CiteScore™: 0.17

ISSN Печать: 0896-2960
ISSN Онлайн: 2162-6553

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Critical Reviews™ in Physical and Rehabilitation Medicine

DOI: 10.1615/CritRevPhysRehabilMed.2019031127
pages 173-183

Functional Outcome Following Lower Extremity Amputation: A Review of Contextual Factors Influencing Function in Low- to Middle-Income Group Countries

Rajani Mullerpatan
Department of Physiotherapy, Mahatma Gandhi Mission School of Physiotherapy, MGM Institute of Health Sciences, Navi Mumbai, Maharashtra, India
Megha Sonkhia
Mahatama Gandhi Mission School of Physiotherapy, Navi Mumbai, Maharashtra, India 410209
Blessy Thomas
Mahatama Gandhi Mission School of Physiotherapy, Navi Mumbai, Maharashtra, India 410209
Swagatika Mishra
MGM Institute's University Department of Prosthetics and Orthotics, MGM Educational Campus, Kamothe, Navi Mumbai 410209
Abhishek Gupta
Department of Mechanical Engineering, Indian Institute of Technology Bombay, Powai, Mumbai 400076
Bela Agarwal
Department of Physiotherapy, Mahatma Gandhi Mission School of Physiotherapy, MGM Institute of Health Sciences, Sector No.1, Plot No. 1 & 2, Kamothe, Navi Mumbai–410209, India

Краткое описание

Lower extremity amputation (LEA) leads to reduced mobility and walking capacity. Contextual factors influencing activities of daily living and community participation in people with LEA vary in low-, middle-, and high-income countries. In the present study, we aimed to review contextual factors influencing function of people with LEA in low- to middleincome countries. A literature search for articles published between January 2000 and 2018 was carried out using PubMed, Google Scholar, and Cochrane reviews databases. In total, 27 relevant articles were identified and reviewed: 8 qualitative studies, 4 manuals and factsheets, 10 descriptive cross-sectional studies, 2 comparative studies and 1 survey.
Several external contextual factors were strongly linked with poor functional outcome, dissatisfaction, and participation restriction: lack of awareness and inadequate rehabilitation and prosthetic services; lack of social security systems; health insurance; poor quality and durability and high cost of prostheses; poor transport facilities; and level of education in low- to middle-income countries. Low income, inaccessible environment, and social stigma associated with amputation reduced functional outcome and community participation. Internal factors like poor coping strategies, negative self-esteem, old-age, female gender, and negative body image were linked with poor functional outcome, whereas strong family support improved participation of people with LEA.
Our review highlights a strong need to build greater awareness on rehabilitation measures following amputation and need for disability inclusive environment to promote community participation in low- to middle-income countries.


  1. Goncalves JE, Knabben RJ, Luz SC. Portraying the amputation of lower limbs: an approach using ICF. Fisioterapiaem Movimento. 2017 Mar;30(1):97-106.

  2. World Health Organization. The rehabilitation of people with amputations. Geneva: WHO; 2004.

  3. Jarnhammer A, Andersson B, Wagle PR, Magnusson L. Living as a person using a lower-limb prosthesis in Nepal. Disability Rehab. 2018 Jun 5;40(12):1426-33.

  4. Akyol Y, Tander B, Goktepe AS, Safaz I, Kuru O, Tan AK. Quality of life in patients with lower limb amputation: Does it affect post-amputation pain, functional status, emotional status and perception of body image? J Musculoskel Pain. 2013 Dec 1;21(4):334-40.

  5. Sinha R, van den Heuvel WJ, Arokiasamy P. Factor's affecting quality of life in lower limb amputees. Prosthetics Ortho Int. 2011 Mar;35(1):90-96.

  6. Andregard E, Magnusson L. Experiences of attitudes in Sierra Leone from the perspective of people with poliomyelitis and amputations using orthotics and prosthetics. Disability Rehab. 2017 Dec 18;39(26):2619-25.

  7. Naidoo U, Ennion L. Barriers and facilitators to utilisation of rehabilitation services amongst persons with lower-limb amputations in a rural community in South Africa. Prosthetics Ortho Int. 2019;43(1):95-103.

  8. Gallagher P, O'Donovan MA, Doyle A, Desmond D. Environmental barriers, activity limitations and participation restrictions experienced by people with major limb amputation. Prosthetics Ortho Int. 2011 Sep;35(3):278-84.

  9. Sahu A, Sagar R, Sarkar S, Sagar S. Psychological effects of amputation: A review of studies from India. Industrial Psych J. 2016 Jan;25(1):4-10.

  10. World Health Organization. Classifications: international classification of functioning, disability and health (ICF) of health and health-related conditions for children and adults. Geneva: WHO; 2001.

  11. Venermo M, Manderbacka K, Ikonen T, Keskimaki I, Winell K, Sund R. Amputations and socioeconomic position among persons with diabetes mellitus, a population-based register study. BMJ Open. 2013 Jan 1;3(4):e002395.

  12. Wyss D, Lindsay S, Cleghorn WL, Andrysek J. Priorities in lower limb prosthetic service delivery based on an international survey of prosthetists in low- and high-income countries. Prosthetics Ortho Int. 2015;39(2):102-11.

  13. Agrawal M, Kalra AS, Joshi M. Correlation of ambulation potential with quality of life in lower limb amputees. Int J Commun Med Public Health. 2017 Oct 25;4(11):4259-65.

  14. Edomwonyi EO, Onuminya JE. An update on major lower limb amputation in Nigeria. J Dent Med Sci. 2014;13:90-96.

  15. Magnusson L, Ramstrand N, Fransson EI, Ahlstrom G. Mobility and satisfaction with lower-limb pros- theses and orthoses among users in Sierra Leone: a cross-sectional study. J Rehab Med. 2014 May 5;46(5):438-46.

  16. Edomwonyi EO, Onuminya JE, Ogbemudia AO, Nwokike OC, Olomu DO. Amputation in Nigeria: the Irrua experience. J Appl Bas Sci. 2013 Dec 31;7(1):64-69.

  17. Saeed U, Rehman M, Dawood R, Khan A, Yasin A. Factors affecting functional outcome after lower extremity amputation. Pakistan Med Assoc J. 2015 Nov;65(3):S-220.

  18. Kam S, Kent M, Khodaverdian A, Daiter L, Njelesani J, Cameron D, Andrysek J. The influence of environmental and personal factors on participation of lower-limb prosthetic users in low-income countries: prosthetic's perspectives. Disability Rehab Assist Technol. 2015 May 4;10(3):245-51.

  19. Andrysek J. Lower-limb prosthetic technologies in the developing world: a review of literature from 1994-2010. Prosthet Ortho Int. 2010;34(4):378-98.

  20. Van Twillert S. Linking scientific and clinical knowledge practices: innovation for prosthetic rehabilitation. Groningen, Germany: University of Groningen; 2015.

  21. World Bank Data Team. New country classifications by income level: 2018-2019. Accessed on Feb 20 2019. Available from: http://blogs.worldbank.org/opendata/new-country-classifications-mcome-lev- el-2018-2019.

  22. Ephraim PL, Dillingham TR, Sector M, Pezzin LE. Epidemiology of limb loss and congenital limb deficiency: a review of the literature. Arch Phys Med Rehab. 2003;84:747-61.

  23. Adegoke BO, Kehinde AO, Akosile CO, Oyeyemi AL. Quality of life of Nigerians with unilateral lower limb amputation. Disabil CBR Inclusive Devel. 2012;23(4):76-89.

  24. Rohwerder B. Disability in South Sudan. K4D Helpdesk Report. Brighton, UK: Institute of Development Studies. Accessed on Feb 22 2019. Available from: https://gsdrc.org/publications/disability-m- south-sudan/.

  25. Shaw J, Challa S, Liu M, Haonga B, Eliezer E. Quality of life and complications in lower extremity amputees in Tanzania: results from a pilot study. 2018 Mar 2;(6):S18.

  26. The Comprehensive National Disability Policy in Afghanistan; 2005. Accessed Feb 20 2019. Available from: http://www.disabilityafghanistan.org/finalpolicy.htm.

  27. Jensen JS, Nilsen R, Thanh NH, Saldana A, Hartz C. Clinical field testing of polyurethane feet for trans- tibial amputees in tropical low-income countries. Prosthetics Ortho Int. 2006 Jan 1;30(2):182-94.

  28. Onuminya JE, Obekpa PO, Ihezue HC, Ukegbu ND, Onabowale BO. Major amputations in Nigeria: a plea to educate traditional bone setters. Trop Doc. 2000 Jul; 30(3):133-35.

  29. Behrouz D, Sousan V , Eissa M, Hadi H. Psychosocial adjustment to lower-limb amputation: a review article. Health MED. 2013;7(2).

  30. Valizadeh S, Dadkhah B, Mohammadi E, Hassankhani H. The perception of trauma patients from social support in adjustment to lower-limb amputation: a qualitative study. Indian J Palliat Care. 2014;20(3):229-38.

  31. Chadda RK, Deb KS. Indian family systems, collectivistic society and psychotherapy. Indian J Psych. 2013;55(Suppl 2):299-309.

  32. World Health Organization. Commission on Social determinants of health. Closing the gap in a generation. Health equity through action on the social determinants of health; 2008. Accessed Feb 22, 2019. Available from: https://www.who.int/social_determinants/thecommission/finalreport/en/.

  33. Desmond D, MacLachlan M. Psychosocial perspectives on post-amputation rehabilitation: a review of disease, trauma and war related literature. Crit Rev Phys Rehabil Med. 2004:77-93.

  34. Breakey JW. Body image: the lower-limb amputee. J ProsthetOrthot. 1997;9:58-66.

  35. Mosaku KS, Akinyoola AL, Fatoye FO, Adegbehingbe OO. Psychological reactions to amputation in a Nigerian sample of amputees. General Hospital Psych. 2009;31(1):20-24.

  36. Horgan O, MacLachlan M. Psychosocial adjustment to lower-limb amputation: a review. Disability Rehab. 2004 Jul 22;26(14-15):837-50.

  37. Bhutani S, Bhutani J, Chhabra A, Uppal R. Living with amputation: anxiety and depression correlates. J Clin Diagn Res. 2016;10(9):RC09-RC12.

  38. Solagberu BA. The scope of amputations in a Nigerian teaching hospital. African J Med Med Sci. 2001 Sep;30(3):225-7.

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