Amputation-specific and generic correlates of participation among Veterans with lower limb amputation

• Published in: PloS one 2022-07, Vol.17 (7), p.e0270753-e0270753
• Main Authors: Erbes, Christopher R, Ferguson, John, Yang, Kalia, Koehler-McNicholas, Sara, Polusny, Melissa A, Hafner, Brian J, Heinemann, Allen W, Hill, Jessica, Rich, Tonya, Walker, Nicole, Weber, Marilyn, Hansen, Andrew
• Format: Article
• Language: English
• Subjects: Amputation; Biology and Life Sciences; Body image; Citizen participation; Clinical outcomes; Community involvement; Community participation; Comorbidity; Confidence intervals; Engineering and Technology; Genetic aspects; Health aspects; Information systems; Medical records; Medicine and Health Sciences; Mental depression; Mental disorders; Mental health; Missing data; Pain; People and places; Post traumatic stress disorder; Prostheses; Quality of life; Regression analysis; Rehabilitation; Research and Analysis Methods; Robustness (mathematics); Social support; Surveys; Veterans
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0270753

Participation in valued interpersonal and community activities is a key component of rehabilitation for Veterans with amputation. The purpose of this study was to identify specific factors that promote or inhibit participation to inform development of interventions that may facilitate participation in desired life activities. A convenience sample of 408 Veterans with at least one lower limb amputation and who had received outpatient care from the Regional Amputation Center (RAC) completed a mailed survey. Participation was measured using the Community Participation Indicators (CPI) Importance, Control, and Frequency scales and the Patient Reported Outcome Measurement Information System (PROMIS) Ability to Participate in Social Roles and Satisfaction with Social Participation scales. Multiple imputation procedures were used to address missing data. Correlates of participation were examined through multiple linear regression. A total of 235 participants completed the survey, a response rate of 58%. Levels of participation, measured with the PROMIS instruments, were 43.2 (SD = 8.1) for Ability and 46.4 (SD = 8.6) for Satisfaction. Regression analyses found robust amputation-specific correlates for participation, including body image and balance confidence. Generic (non-amputation specific) correlates for participation included depression and pain interference. Development of treatment approaches and devices that can address body image, balance confidence, pain, and mental health concerns such as depression have the potential to enhance the participation and rehabilitation of Veterans with lower limb amputation.