Health-related quality of life among lower limb amputees using prostheses in Nepal: a cross-sectional study

Lower limb amputation significantly impacts individuals' quality of life, with prostheses playing a crucial role in rehabilitation and mobility restoration. In Nepal, where access to advanced medical care is limited, understanding the factors affecting the well-being of prosthesis users is essential for optimizing rehabilitation services. This study investigates the sociodemographic and health-related variables influencing the quality of life among lower-limb amputees using prostheses in Nepal.

A cross-sectional study was conducted at a super-specialized disability care center within a tertiary care hospital. The study included 43 amputees who had received prostheses at least five years prior and were regular users. The sample was drawn from patients at the same hospital. The study collected data on sociodemographic characteristics, health components, and pain experiences. Health-related quality of life (HrQoL) was assessed using the SF-12 tool, with scores above 50 indicating high HrQoL on the Mental Component Summary (MCS) and Physical Component Summary (PCS). Scores below 50 indicated low HrQoL. Factors associated with these variables were analyzed using Chi-square (χ²) at a 95% confidence interval.

Our study assessed the health-related quality of life among lower limb amputees, finding that 76.74% of participants scored high in mental health and 81.40% in physical health. Significant associations were identified between age and marital status with the Mental Component Summary (MCS) and Physical Component Summary (PCS). Additionally, the reason for amputation and the experience of the Phantom pain were linked to the MCS. Factors like treatment for stump pain, perceived effectiveness of stump pain treatment, and residual stump pain were associated with both the PCS and MCS, while actions taken for stump pain and extremity dominance were associated significantly with the PCS. The level of amputation and treatment for phantom pain also showed significant association. All associations were significant (p > 0.05) at a 95% confidence interval.

These findings indicate that age, marital status, extremity dominance, reason for amputation, stump pain treatment, and pain management are critical factors influencing the quality of life among lower limb amputees. The study underscores the need for comprehensive rehabilitation programs incorporating effective pain management, spouse support, and tailored interventions based on individual demographic and clinical characteristics.