Predictors of quality of life in individuals with non-traumatic unilateral transtibial amputation

Quality of life is a crucial outcome in evaluating adjustment to prostheses for individuals with non-traumatic lower limb amputation (LLA). This study aimed to identify prostheses-related factors that predict the quality of life in people with non-traumatic, unilateral, transtibial amputation.

This cross-sectional study surveyed 168 people who have experienced non-traumatic, unilateral, transtibial amputations and use prosthesis. They completed the 12-item short-form (SF-12) health survey and the comprehensive lower limb amputee socket survey (CLASS). We did correlation analyses to explore relationships between the variables and quality of life, followed by multiple regression analyses to assess their impact on quality of life outcomes.

Quality of life had a strong positive association with comfort (r = 0.65, p = 0.001). There was a moderate positive association with socket stability (r = 0.46, p < 0.001) and suspension (r = 0.48, p = 0.001), as well as a weak positive association with appearance (r = 0.35, p = 0.001). In the final regression model, the comfort subscale of CLASS was the strongest predictor of quality of life (β = 0.51, p = 0.001).

This study highlights that prosthesis socket comfort is the primary prosthesis-related factor predicting the quality of life for individuals with non-traumatic, unilateral, transtibial amputation. Thus, rehabilitation should prioritize modifiable factors, especially optimal socket fitting. Identifying user needs is essential for better prosthesis use, as enhancements in other prosthetic components do not necessarily improve quality of life without considering socket comfort.