FARKLI FONKSİYONEL MOBİLİTE DÜZEYİNE SAHİP TRANSTİBİAL AMPUTELERDE PROTEZE UYUM, VÜCUT İMAJI VE YAŞAM KALİTESİNİN KARŞILAŞTIRILMASI

Yıl 2022, , 62 - 73, 23.12.2022

Mehmet Kurtaran , Derya Çelik , İpek Yeldan

https://doi.org/10.52881/gsbdergi.1172645

Öz

Bu çalışmada transtibial amputasyonlu hastalarda mobilite düzeylerine göre proteze uyum, vücut imajı ve yaşam kalitesi sonuçların karşılaştırılması amaçlandı. Çalışmaya 40-60 yaş aralığında unilateral transtibial 43 ampute dahil edildi. Katılımcılar fonksiyonel mobilite seviyelerine göre K2 (n=17) ve K3 (n=26) olmak üzere iki gruba ayrıldı. Proteze uyum Trinity Amputasyon ve Protez Deneyim Ölçeği (TAPES) ile, vücut imajı Ampute Vücut İmajı Skalası (AVİS) ile, yaşam kalitesi ise Nottingham Sağlık Profili (NSP) ile değerlendirildi. K2 grubunun K3 grubuna göre vücut imajı algısının ve yaşam kalitesinin daha kötü etkilendiği, daha fazla fonksiyonel ve sosyal kısıtlılık yaşadığı tespit edildi (p<0,05). Vücut imajı algısında K2 grubunun fonksiyonel faktör yönünden daha kötü etkilendiği tespit edildi. Yaşam kalitesi sonuçlarında K2 grubunun K3 grubuna göre daha fazla problem yaşadıkları görüldü. K2 grubunda TAPES ölçeğinden genel uyum, kısıtlanmaya uyum, protez memnuniyeti ile AVİS arasında, K3 grubunda ise atletik kısıtlanma ile AVİS arasında ilişki bulundu. K2 grubunda vücut imajı ile yaşam kalitesi arasında ilişki tespit edilirken K3 grubunda ilişki gözlemlenmedi. Çalışmamızın sonuçları K2 mobilite düzeyindeki amputelerin proteze uyumunda fonksiyonel ve sosyal kısıtlılıklar yaşadığını göstermektedir. Transtibial amputelerde yaşam kalitesinin iyileştirilmesinde K2 mobilite düzeyine sahip olanlarda vücut imajı ile proteze uyum ve memnuniyeti, K3 mobilite düzeyinde ise atletik kısıtlama dikkate alınmalıdır.

Anahtar Kelimeler

Ampute, protez uyumu, vücut imajı, yaşam kalitesi

COMPARISON OF PROSTHESIS ADAPTATION, BODY IMAGE, AND QUALITY OF LIFE IN TRANSTIBIAL AMPUTEES WITH DIFFERENT LEVEL OF FUNCTIONAL MOBILITY

Öz

In this study, it was aimed to compare the results of prosthesis adaptation, body image, and quality of life according to mobility levels in patients with transtibial amputation. 43 unilateral transtibial amputees aged 40-60 years were included in the study. The participants were divided into two groups according to their functional mobility levels: K2(n=17) and K3(n=26). Prosthesis adaptation was assessed with the Trinity Amputation and Prosthesis Experience Scale (TAPES), body image with the Amputee Body Image Scale (ABIS), and quality of life with the Nottingham Health Profile (NHP). It was found that the body image perception and quality of life of the K2 group were worsened and had more functional and social limitations compared to the K3 group (p<0.05). In the K2 group, there was a correlation between the TAPES scale sub-parameters of general adaptation, compliance with restraint, prosthesis satisfaction, and ABIS, while in the K3 group, a relationship was found between athletic limitation and ABIS. While a significant relationship was found between body image and quality of life in the K2 group, no relationship was observed in the K3 group. The results of our study show that amputees with K2 mobility experience functional and social limitations in prosthesis adaptation. In order to improve the quality of life in transtibial amputees, compliance and satisfaction with body image and prosthesis should be taken into account in those with K2 mobility level and athletic restriction should be taken into account at K3 mobility level.

Anahtar Kelimeler

Amputees, prosthesis fitting, body image, quality of life

Kaynakça

• Molina-Rueda F, Molero-Sánchez A, Carratalá-Tejada M, Cuesta-Gómez A, Miangolarra-Page JC, Alguacil-Diego IM. Limits of stability in patients with vascular (due to diabetes) and nonvascular unilateral transtibial amputation: a cross-sectional study. Int J Rehabil Res. 2017; 40(3):227-31.
• Knežević A, Salamon T, Milankov M, Ninković S, Jeremić Knežević M, Tomašević Todorović S. Assessment of quality of life in patients after lower limb amputation. Med Pregl. 2015; 68(3-4):103-8.
• Molina CS, Faulk J. Lower extremity amputation. StatPearls Publishing, Treasure Island (FL) 2021.
• Fortington LV, Rommers GM, Geertzen JH, Postema K, Dijkstra PU. Mobility in elderly people with a lower limb amputation: a systematic review. J Am Med Dir Assoc. 2012; 13(4):319-25.
• Meier RH, Melton D. Ideal functional outcomes for amputation levels. Phys Med Rehabil Clin N Am. 2014; 25(1):199-212.
• Asano M, Rushton P, Miller WC, Deathe BA. Predictors of quality of life among individuals who have a lower limb amputation. Prosthet Orthot Int. 2008; 32(2):231-43.
• Baars EC, Schrier E, Dijkstra PU, Geertzen JHB. Prosthesis satisfaction in lower limb amputees: a systematic review of associated factors and questionnaires. Medicine (Baltimore). 2018; 97(39):e12296.
• Sansam K, Neumann V, O'Connor R, Bhakta B. Predicting walking ability following lower limb amputation: a systematic review of the literature. J Rehabil Med. 2009; 41(8):593-603.
• Molero-Sánchez A, Molina-Rueda F, Alguacil-Diego IM, Cano-de la Cuerda R, Miangolarra-Page JC. Comparison of stability limits in men with traumatic transtibial amputation and a nonamputee control group. PM R. 2015; 7(2):123-9.
• Pedlow H, Cormier A, Provost M, Bailey S, Balboul G, Coucill A, et al. Patient perspectives on information needs for amputation secondary to vascular surgery: what, when, why, and how much? J Vasc Nurs. 2014; 32(3):88-98.
• Holzer LA, Sevelda F, Fraberger G, Bluder O, Kickinger W, Holzer G. Body image and self-esteem in lower-limb amputees. PLoS One. 2014; 9(3):e92943.
• Borrenpohl D, Kaluf B, Major MJ. Survey of U.S. practitioners on the validity of the medicare functional classification level system and utility of clinical outcome measures for aiding k-level assignment. Arch Phys Med Rehabil. 2016; 97(7):1053-63.
• Gallagher P, MacLachlan M. Development and psychometric evaluation of the Trinity Amputation and Prosthesis Experience Scales (TAPES). Rehabil Psychol. 2000; 45(2):130.
• Topuz S, Ülger Ö, Yakut Y, Gül Şener F. Reliability and construct validity of the Turkish version of the Trinity Amputation and Prosthetic Experience Scales (TAPES) in lower limb amputees. Prosthet Orthot Int. 2011; 35(2):201-6.
• Breakey JW. Body image: the lower-limb amputee. J Prosthet Orthot. 1997; 9(2):58-66.
• Bumin G, Bayramlar K, Yakut Y, Sener G. Cross cultural adaptation and reliability of the Turkish version of Amputee Body Image Scale (ABIS). J Back Musculoskelet Rehabil. 2009; 22(1):11-6.
• Demet K, Guillemin F, Martinet N, Andre J. Nottingham Health Profile: reliability in a sample of 542 subjects with major amputation of one or several limbs. Prosthet Orthot Int. 2002; 26(2):120-3.
• Kücükdeveci A, McKenna S, Kutlay S, Gürsel Y, Whalley D, Arasil T. The development and psychometric assessment of the Turkish version of the Nottingham Health Profile. Int J Rehabil Res. 2000; 23(1):31-8.
• Jiménez Buñuales MT, González Diego P, Martín Moreno JM. [International classification of functioning, disability and health (ICF) 2001]. Rev Esp Salud Publica. 2002;76(4):271-9.
• Miller WC, Deathe AB, Speechley M, Koval J. The influence of falling, fear of falling, and balance confidence on prosthetic mobility and social activity among individuals with a lower extremity amputation. Arch Phys Med Rehabil. 2001; 82(9):1238-44.
• Peek ME. Gender differences in diabetes-related lower extremity amputations. Clin Orthop Relat Res. 2011; 469(7):1951-5.
• Hijmans JM, Dekker R, Geertzen JHB. Pre-operative rehabilitation in lower-limb amputation patients and its effect on post-operative outcomes. Med Hypotheses. 2020; 143:110134.
• MacCallum KP, Yau P, Phair J, Lipsitz EC, Scher LA, Garg K. Ambulatory status following major lower extremity amputation. Ann Vasc Surg. 2021; 71:331-7.
• O'Neill BF, Evans JJ. Memory and executive function predict mobility rehabilitation outcome after lower-limb amputation. Disabil Rehabil. 2009; 31(13):1083-91.
• Sinha R, Van Den Heuvel WJ. A systematic literature review of quality of life in lower limb amputees. Disabil Rehabil. 2011; 33(11):883-99.
• Asano M, Rushton P, Miller WC, Deathe BA. Predictors of quality of life among individuals who have a lower limb amputation. Prosthet Orthot Int. 2008;32(2):231-43.
• Sinha R, van den Heuvel WJ, Arokiasamy P. Factors affecting quality of life in lower limb amputees. Prosthet Orthot Int. 2011; 35(1):90-6.
• Burger H, Marinček Č. Return to work after lower limb amputation. Disabil Rehabil. 2007; 29(17):1323-9.
• van der Schans CP, Geertzen JH, Schoppen T, Dijkstra PU. Phantom pain and health-related quality of life in lower limb amputees. J Pain Symptom Manage. 2002; 24(4):429-36.
• Atherton R, Robertson N. Psychological adjustment to lower limb amputation amongst prosthesis users. Disabil Rehabil. 2006; 28(19):1201-9.
• Mayer A, Kudar K, Bretz K, Tihanyi J. Body schema and body awareness of amputees. Prosthet Orthot Int. 2008; 32(3):363-82.
• Aran OT, Üçgül MŞ, Ekici G. Alt ekstremite ampütelerinde vücut imajı algısı ve yaşam memnuniyeti ilişkisi. Ergoterapi ve Rehabilitasyon Dergisi. 2018; 6(2):89-94.
• Öztürk Rİ, Öztürk GK. Alt ekstremite amputasyonu olan bireylerin vücut imajı: kesitsel çalışma. Turkiye Klinikleri J Med Sci. 2021; 41(3):205-13.
• Murray CD, Fox J. Body image and prosthesis satisfaction in the lower limb amputee. Disabil Rehabil. 2002; 24(17):925-31.
• Zidarov D, Swaine B, Gauthier-Gagnon C. Quality of life of persons with lower-limb amputation during rehabilitation and at 3-month follow-up. Arch Phys Med Rehabil. 2009; 90(4):634-45.
• Eiser C, Darlington A-SE, Stride CB, Grimer R. Quality of life implications as a consequence of surgery: limb salvage, primary and secondary amputation. Sarcoma. 2001; 5(4):189-95.
• McDonald S, Sharpe L, MacCann C, Blaszczynski A. The role of body image on psychosocial outcomes in people with diabetes and people with an amputation. Front Psychol. 2021; 11:614369.
• Beisheim-Ryan EH, Hicks GE, Pohlig RT, Medina J, Sions JM. Body image and perception among adults with and without phantom limb pain. PM R. 2021.
• Ng SS, Naing L, Idris FI, Pande K. What is the quality of life of transtibial amputees in Brunei Darussalam? Malays Orthop J. 2020; 14(2):39-46.
• Davie-Smith F, Coulter E, Kennon B, Wyke S, Paul L. Factors influencing quality of life following lower limb amputation for peripheral arterial occlusive disease: a systematic review of the literature. Prosthet Orthot Int. 2017; 41(6):537-47.
• Schürmann T, Beckerle P, Preller J, Vogt J, Christ O. Theoretical implementation of prior knowledge in the design of a multi-scale prosthesis satisfaction questionnaire. Biomed Eng Online. 2016; 15(3):143.
• Pran L, Baijoo S, Harnanan D, Slim H, Maharaj R, Naraynsingh V. Quality of life experienced by major lower extremity amputees. Cureus. 2021; 13(8):e17440.
• Taylor SM, Kalbaugh CA, Blackhurst DW, Hamontree SE, Cull DL, Messich HS, et al. Preoperative clinical factors predict postoperative functional outcomes after major lower limb amputation: an analysis of 553 consecutive patients. J Vasc Surg. 2005;42(2):227-34.
• Marshall C, Barakat T, Stansby G. Amputation and rehabilitation. Surgery (Oxford). 2016; 34(4):188-91.