Open AccessImpact of prostheses on quality of life and functional status of transfemoral amputees in Tanzania
Author(s) -
Ericka P. von Kaeppler,
Alexander Hetherington,
Claire A. Donnelley,
Sadia Ali,
Corin Shirley,
Sravya Challa,
Emily Mochizuki Lutyens,
Billy Haonga,
Saam Morshed,
Jan Andrysek,
David Shearer
Publication year - 2021
Publication title -
african journal of disability
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.301
H-Index - 8
eISSN - 2226-7220
pISSN - 2223-9170
DOI - 10.4102/ajod.v10i0.839
Subject(s) - prosthesis , medicine , amputation , quality of life (healthcare) , physical therapy , surgery , nursing
Background The rise of diabetes and traumatic injury has increased limb loss-related morbidity in low- and middle-income countries (LMICs). Despite this, the majority of amputees in LMICs have no access to prosthetic devices, and the magnitude of prosthesis impact on quality of life (QOL ) and function has not been quantified. Objectives Quantify the impact of prostheses on QOL and function in Tanzanian transfemoral amputees. Method A prospective cohort study was conducted. Transfemoral amputees at Muhimbili Orthopaedic Institute were assessed twice before and three times after prosthetic fitting using EuroQol-5D-3L (EQ-5D-3L), Prosthetic Limb Users Survey of Mobility (PLUS-M), 2-minute walk test (2MWT) and Physiologic Cost Index (PCI). Data were analysed for change over time. Subgroup analysis was performed for amputation aetiology (vascular or non-vascular) and prosthesis use. Results Amongst 30 patients, EQ-5D, PLUS-M and 2MWT improved after prosthesis provision ( p < 0.001). EuroQol-5D increased from 0.48 to 0.85 at 1 year ( p < 0.001). EuroQol-5D and 2MWT were higher in non-vascular subgroup ( p < 0.030). At 1-year, 84% of non-vascular and 44% of vascular subgroups reported using their prosthesis ( p = 0.068). Conclusion Prosthesis provision to transfemoral amputees in an LMIC improved QOL and function. This benefit was greater for non-vascular amputation aetiologies. Quality of life and function returned to pre-prosthesis levels with discontinued use of prosthesis.