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Health-related quality of life in persons with dysvascular and traumatic lower limb amputation—a systematic review
WCPT Congress 2015 / Physiotherapy 2015; Volume 101, Supplement 1 eS633–eS832
Research Report Platform Presentation Number: RR-PL-3598 Monday 4 May 2015 15:02 Room 328–329 HEALTH-RELATED QUALITY OF LIFE IN PERSONS WITH DYSVASCULAR AND TRAUMATIC LOWER LIMB AMPUTATION—A SYSTEMATIC REVIEW C. Shields, H. Thorp, G. Hendry, P. Jayakaran University of Otago, School of Physiotherapy, Dunedin, New Zealand Background: Lower limb amputation inherently affects the physical and psychological wellbeing of an individual and will therefore influence their quality of life (QoL). Although prosthetic rehabilitation of individuals with a lower limb amputation aims to re-establish their physical ability, it may not be restored to the pre-operative functional levels. Individuals with an amputation due to a dysvascular disease (diabetes and peripheral vascular disease) are even more challenged in general functioning and well-being when compared with individuals with an amputation due to other aetiologies. With the number of dysvascular amputations increasing worldwide in the recent decade, it is essential to understand its influence on the QoL when compared with amputation of other aetiologies, such as trauma. Purpose: The purpose of this systematic review was to compare the health-related QoL of individuals with unilateral dysvascular amputation with that of traumatic amputation. Methods: A systematic search was performed on 10 databases to identify prospective studies investigating healthrelated QoL following a dysvascular and/or traumatic amputation. Studies measuring the QoL using the ShortForm Health Survey (SF-36) in adults were included in the review. All included studies were screened for methodological quality using the Downs and Black questionnaire. The details of the studies and their SF-36 data were extracted and considered for further analysis. The data extracted were: Scores of the SF-36 sub scales; namely Physical Functioning, Role-Physical, Bodily Pain, General Health, Vitality, Social Functioning, Role-Emotional and Mental Functioning. As the studies and the participants of the studies were heterogeneous, the data were analysed descriptively. Results: Of the 2308 articles located by the electronic search, 12 studies met the final criteria to be included in the study; nine studies were on individuals with traumatic amputation and three were on dysvascular amputation. The sample size of the studies ranged from six to 461 participants. The average age for the 10 studies that reported age of participants was 40.7 years, with an age range of 24.4 to 66.3 years. The estimated overall SF-36 score was higher in individuals with traumatic amputations (487.7) than in dysvascular amputations (400.7). The average Physical Functioning and
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Role-Physical scores of individuals with a traumatic amputation (56.27 and 57.35 respectively) estimated from the included studies were higher than individuals with a dysvascular amputation (28.63 and 18.10 respectively). In contrast, the average Pain and Mental Health sections of individuals with a dysvascular amputation (56.77 and 61.09 respectively) were slightly higher than traumatic amputation (53.13 and 59.84 respectively). Conclusion(s): Individuals with a traumatic amputation have better overall QoL than individuals with a dysvascular amputation. However, a paradox exists between the two groups of amputation in the Physical Functioning and Pain/Mental health scores. Future research with bettermatched participants is needed to draw further conclusions. Implications: Differences observed in the Pain/Mental Health scores suggest a need for focused psychological rehabilitation/coping strategies for individuals with traumatic amputation. Similarly, the physical functioning scores suggest the need for additional attention on the rehabilitation of physical functioning in individuals with a dysvascular amputation. Keywords: Lower limb amputation; Health; Quality of life Funding acknowledgements: This study did not receive financial support from any funding body. Ethics approval: Ethical approval was not required for this study. http://dx.doi.org/10.1016/j.physio.2015.03.3514 Special Interest Report Poster Presentation Number: SI-PO-08-01-Sun Sunday 3 May 2015 12:15 Exhibit halls 401–403 ENHANCING COMPETENCIES AND SKILLS FOR EVIDENCE BASED SERVICE INNOVATIONS IN PT EDUCATION I. Jeglinsky 1 , J. Kettunen 1 , H. Anttila 2 , A. Kärki 3 , C. Wikström-Grotell 1 1 Arcada
University of Applied Sciences, Department of Health and Welfare, Helsinki, Finland; 2 National Institute for Health and Welfare, Service System Department, Health and Social Services Development Unit, Disability and Society Team, Helsinki, Finland; 3 Satakunta University of Applied Sciences, Research, Innovation and Business Services, Pori, Finland Background: Physiotherapy (PT) education and practice should be based on scientific knowledge and needs in PT practice. National and international physiotherapy guidelines help clinicians to choose effective treatment methods. However, the national guidelines include only partly physiotherapy interventions. Research results are transformed to practice slowly. Current PT education teaches the students
Research Report Platform Presentation Number: RR-PL-3598 Monday 4 May 2015 15:02 Room 328–329 HEALTH-RELATED QUALITY OF LIFE IN PERSONS WITH DYSVASCULAR AND TRAUMATIC LOWER LIMB AMPUTATION—A SYSTEMATIC REVIEW C. Shields, H. Thorp, G. Hendry, P. Jayakaran University of Otago, School of Physiotherapy, Dunedin, New Zealand Background: Lower limb amputation inherently affects the physical and psychological wellbeing of an individual and will therefore influence their quality of life (QoL). Although prosthetic rehabilitation of individuals with a lower limb amputation aims to re-establish their physical ability, it may not be restored to the pre-operative functional levels. Individuals with an amputation due to a dysvascular disease (diabetes and peripheral vascular disease) are even more challenged in general functioning and well-being when compared with individuals with an amputation due to other aetiologies. With the number of dysvascular amputations increasing worldwide in the recent decade, it is essential to understand its influence on the QoL when compared with amputation of other aetiologies, such as trauma. Purpose: The purpose of this systematic review was to compare the health-related QoL of individuals with unilateral dysvascular amputation with that of traumatic amputation. Methods: A systematic search was performed on 10 databases to identify prospective studies investigating healthrelated QoL following a dysvascular and/or traumatic amputation. Studies measuring the QoL using the ShortForm Health Survey (SF-36) in adults were included in the review. All included studies were screened for methodological quality using the Downs and Black questionnaire. The details of the studies and their SF-36 data were extracted and considered for further analysis. The data extracted were: Scores of the SF-36 sub scales; namely Physical Functioning, Role-Physical, Bodily Pain, General Health, Vitality, Social Functioning, Role-Emotional and Mental Functioning. As the studies and the participants of the studies were heterogeneous, the data were analysed descriptively. Results: Of the 2308 articles located by the electronic search, 12 studies met the final criteria to be included in the study; nine studies were on individuals with traumatic amputation and three were on dysvascular amputation. The sample size of the studies ranged from six to 461 participants. The average age for the 10 studies that reported age of participants was 40.7 years, with an age range of 24.4 to 66.3 years. The estimated overall SF-36 score was higher in individuals with traumatic amputations (487.7) than in dysvascular amputations (400.7). The average Physical Functioning and
eS673
Role-Physical scores of individuals with a traumatic amputation (56.27 and 57.35 respectively) estimated from the included studies were higher than individuals with a dysvascular amputation (28.63 and 18.10 respectively). In contrast, the average Pain and Mental Health sections of individuals with a dysvascular amputation (56.77 and 61.09 respectively) were slightly higher than traumatic amputation (53.13 and 59.84 respectively). Conclusion(s): Individuals with a traumatic amputation have better overall QoL than individuals with a dysvascular amputation. However, a paradox exists between the two groups of amputation in the Physical Functioning and Pain/Mental health scores. Future research with bettermatched participants is needed to draw further conclusions. Implications: Differences observed in the Pain/Mental Health scores suggest a need for focused psychological rehabilitation/coping strategies for individuals with traumatic amputation. Similarly, the physical functioning scores suggest the need for additional attention on the rehabilitation of physical functioning in individuals with a dysvascular amputation. Keywords: Lower limb amputation; Health; Quality of life Funding acknowledgements: This study did not receive financial support from any funding body. Ethics approval: Ethical approval was not required for this study. http://dx.doi.org/10.1016/j.physio.2015.03.3514 Special Interest Report Poster Presentation Number: SI-PO-08-01-Sun Sunday 3 May 2015 12:15 Exhibit halls 401–403 ENHANCING COMPETENCIES AND SKILLS FOR EVIDENCE BASED SERVICE INNOVATIONS IN PT EDUCATION I. Jeglinsky 1 , J. Kettunen 1 , H. Anttila 2 , A. Kärki 3 , C. Wikström-Grotell 1 1 Arcada
University of Applied Sciences, Department of Health and Welfare, Helsinki, Finland; 2 National Institute for Health and Welfare, Service System Department, Health and Social Services Development Unit, Disability and Society Team, Helsinki, Finland; 3 Satakunta University of Applied Sciences, Research, Innovation and Business Services, Pori, Finland Background: Physiotherapy (PT) education and practice should be based on scientific knowledge and needs in PT practice. National and international physiotherapy guidelines help clinicians to choose effective treatment methods. However, the national guidelines include only partly physiotherapy interventions. Research results are transformed to practice slowly. Current PT education teaches the students