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Amputee -Improves quality of life

Evidence Summary
A review of 47 papers identified 6 studies that had reviewed the relationship between participation in regular physical activity or sport and quality of life 1. They found that participation in physical activity reduced following an amputation, but that amputees engaging in regular sport or physical activity reported a better quality of life. A number of factors may contribute to an improved quality of life, including an increased number of social contacts, acceptance of their disability, improved motor skills and a greater knowledge of about what they can do to participate in sport and physical activity. It was noted that a greater proportion of participants in these studies had undergone a traumatic amputation than would be expected in the general population. A further systematic review identified that in military veterans that had undergone a lower limb amputation for trauma, higher levels of physical activity was positively associated with better physical and mental health related quality of life measures 2. Their conclusion was that physical activity and sport should be promoted in this cohort. Social interactions and relationships are known to be a key determinant of quality of life in lower limb amputees, and physical activity interventions, whilst important, should not compromise these 3.

Quality of evidence
Grade B – Moderate quality.

Strength of recommendation
Grade 1 – Strong

Conclusion
On the basis of the existing evidence, the majority of lower limb amputees should be encouraged to undertake regular physical activity. However, it is important that this is not at the expense of social interaction, and regular physical activity should be encouraged within a supportive social environment.

Lower limb amputations are performed for a number of clinical indications. The majority of physical activity evidence exists for prosthetic users and for dysvascular amputees, but the benefits of physical activity are not exclusive to these groups and should be shared with all lower limb amputees. Lower limb amputees wishing to increase their physical activity levels should be encouraged to do so and signposting them to appropriate resources may empower and assist them in doing so.

References

  1. Bragaru M, Dekker R, Geertzen JHB, et al. Amputees and Sports A Systematic Review. Sports Medicine 2011;41(9):721-40. doi: 10.2165/11590420-000000000-00000
  2. Christensen J, Ipsen T, Doherty P, et al. Physical and social factors determining quality of life for veterans with lower-limb amputation(s): a systematic review. Disability and Rehabilitation 2016;38(24-26):2345-53. doi: 10.3109/09638288.2015.1129446
  3. Deans SA, McFadyen AK, Rowe PJ. Physical activity and quality of life: A study of a lower-limb amputee population. Prosthetics and Orthotics International 2008;32(2):186-200. doi: 10.1080/03093640802016514

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