Adaptation to prostheses among patients with major lower-limb amputations and its association with sociodemographic and clinical data

CONTEXT AND OBJECTIVE: Lower-limb amputation compromises patients' independence and autonomy, and therefore they should be referred for rehabilitation in order to adapt to prostheses and regain autonomy. The aim here was to assess adaptation to prostheses among patients with major lower-limb amputations and its association with sociodemographic and clinical data. DESIGN AND SETTING: This was a cross-sectional study in the city of Aracaju, Brazil. METHODS: The patients were identified by primary healthcare teams. The inclusion criterion was that these should be patients who underwent major lower-limb amputations of any etiology. Associations between sociodemographic and clinical variables and the adaptation to lower-limb prostheses were assessed. RESULTS: 149 patients were examined. Adaptation to the prosthesis occurred in 40% (60/149) of them, but only 62% (37/60) were using it. Adaptation occurred more often among male patients (P = 0.017) and among those who had a higher educational level (P = 0.013), with a longer time since amputation (P = 0.049) and when the etiology was trauma (P = 0.003). The result from logistic regression analysis showed that only patients with low education (P = 0.031) were significantly associated with a lower frequency of adaptation to prostheses. CONCLUSION: It was found that patients with a low educational level became adapted to the prosthesis less frequently. CONTEXTO E OBJETIVO: A amputação de membros inferiores compromete a independência e a autonomia dos pacientes, por isso, eles devem ser encaminhados para a reabilitação para a adaptação das próteses e assim viabilizar a recuperação da autonomia. O objetivo foi avaliar a adaptação de prótese em pacientes com amputações maiores de membros inferiores e sua associação com dados sócio-demográficos e clínicos.

研究背景与目的：下肢截肢会损害患者的独立能力与自主意识，因此需将患者转诊接受康复训练，以帮助其适配假肢（prosthesis）并重获自主能力。本研究旨在评估重大下肢截肢患者的假肢适配情况，及其与社会人口学及临床资料的相关性。研究设计与实施地点：本研究为在巴西阿拉卡茹市开展的横断面研究。研究方法：研究对象由初级医疗团队筛选确认。纳入标准为因任何病因接受重大下肢截肢手术的患者。本研究分析了社会人口学与临床变量同下肢假肢适配情况之间的相关性。研究结果：本研究共纳入149例患者。其中40%（60/149）的患者实现了假肢适配，但仅62%（37/60）的适配患者正在使用假肢。男性患者（P=0.017）、受教育程度更高的患者（P=0.013）、截肢后病程更长的患者（P=0.049）以及因创伤导致截肢的患者（P=0.003）的假肢适配率显著更高。Logistic回归分析（logistic regression）结果显示，仅低受教育程度患者（P=0.031）与更低的假肢适配频率存在显著相关性。研究结论：本研究发现，低受教育程度患者的假肢适配率显著更低。