Assessment of the Quality of Life in Patients with Lower Limb Amputations

Abstract

Lower limb amputation is a life-altering event that significantly impacts an individual’s physical, psychological, social, and environmental well-being. The present study aimed to assess the quality of life (QoL) among lower limb amputees using the WHOQOL-BREF questionnaire. This cross-sectional study was conducted at D.Y. Patil Hospital, Navi Mumbai, and included participants of varied age groups and educational backgrounds with unilateral or bilateral amputations. Data on demographics, causes of amputation, comorbidities, and levels of amputation were collected alongside QoL scores across four domains. Results indicated that the majority of amputations were due to diabetic foot complications (60%), with Ray’s amputation being the most common surgical procedure performed. The physical health domain recorded the lowest mean score (48%), highlighting mobility limitations and dependence on medical care as key concerns. Psychological health (57%), social relationships (67%), and environmental well-being (62%) were comparatively better but still demonstrated areas of impairment. The findings suggest that while amputees can achieve moderate adaptation in psychosocial and environmental aspects, physical limitations remain a major determinant of reduced QoL. This study emphasizes the importance of holistic rehabilitation, encompassing physical, psychological, and social support strategies, to enhance the overall quality of life in lower limb amputees.

Introduction

Amputation, the surgical removal of a body part, significantly impacts an individual’s physical, psychological, emotional, and social well-being, affecting their quality of life (QoL). India has a large population of amputees, mainly males from rural, low-income backgrounds, with traumatic accidents and diabetic foot being common causes. Below-knee amputations are more common and generally associated with better survival than above-knee amputations.

The World Health Organization (WHO) defines health holistically, including mental and social well-being, and uses the WHOQOL-BREF questionnaire to assess QoL across physical, psychological, social, and environmental domains. Physiotherapists play a key role in assessing and improving the QoL of amputees through regular evaluations using tools like WHOQOL-BREF, which helps identify rehabilitation barriers and tailor interventions.

Study Details:

• Conducted at D.Y. Patil Hospital, Navi Mumbai, with convenient sampling.

• Data collected via WHOQOL-BREF questionnaire and demographic details.

• Majority were males (86.7%), aged 18–74 (mean 53), mostly with education up to 10th grade.

• Diabetes was the leading comorbidity; diabetic foot was the primary cause of amputation.

• Most had unilateral amputations, with Ray’s and transtibial amputations being most common.

Results:

• 50% reported satisfaction with their overall QoL; health satisfaction was lower.

• Physical domain: Many experienced moderate to severe pain, needed medical treatment, and had limited mobility, but showed moderate satisfaction in work capacity.

• Psychological domain: Mixed responses on life enjoyment, meaning, body image acceptance, and self-satisfaction; negative feelings were common.

• Social domain: Most were satisfied with personal relationships and friend support, but less so with sexual relations.

• Environmental domain: Generally felt safe and satisfied with living conditions and health services, but many faced financial difficulties and lacked leisure opportunities.

Conclusion

This study shows that lower limb amputations significantly influence the QoL and the physical domain was most affected at a mean of 48% followed by the psychological domain at 57%.

References

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Copyright

Copyright © 2025 Sanjeevani Sharan, Sukhada Prabhu. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.