Body Image and Prosthesis Satisfaction in the Lower Limb Amputee

BODY IMAGE AND PROSTHESIS SATISFACTION

IN THE LOWER LIMB AMPUTEE

Craig D. Muray and Jezz Fox

Address all correspondence to:

Craig D. Murray

Department of Psychology

Liverpool Hope

Hope Park

Liverpool

L16 9JD

UNITED KINGDOM

Tel: +44 +151 291 3883

E-mail: murrayc@hope.ac.uk

BODY IMAGE AND PROSTHESIS SATISFACTION

IN THE LOWER LIMB AMPUTEE

Keywords amputee, body image, pain, prosthesis satisfaction

Abstract

Purpose: This study examines the relationship between prosthesis satisfaction and

body image in lower limb prosthesis users, and the gendered variations within these

relationships.

Method: A total of 44 valid responses were obtained to an Internet survey regarding

prosthesis satisfaction, body image, and phantom pain. Spearman Rho correlations

were calculated for these three domains.

Results: Moderate to high negative correlations were observed between Body Image

Disturbance and Prosthesis Satisfaction. These were consistent across genders. Other

relationships were also revealed, including positive correlations between Prosthesis

Satisfaction with hours of use and negative correlations between Prosthesis

Satisfaction and pain experience, though strong differences between genders were

observed for these. The length of time for which respondents had had their prosthesis

bore little relation to other variables.

Conclusion: The present research is instructive of the close relationship between body

image and prosthesis satisfaction, as well as gender variations in these relationships, in

lower-limb prosthesis users. These findings have implications for targeted service

provision in prosthetic rehabilitation.

Introduction

Prosthetic limbs are commonly used by people with limb loss (acquired amputation)

and limb absence (congenital deficiency) to restore or imbue some of the function

and/or cosmesis of an anatomical limb. Both people with acquired amputations and

people with congenital limb absence will be encouraged to use prostheses by a variety

of professionals as part of a rehabilitation process.1-4 However, published research on

the levels of prosthesis use among those with a lower limb amputation varies

considerably.5-7

The incidence of lower-limb amputations is 11 times greater than that for upper-limb

amputation8, and the majority of all amputations occur in older adults9, most

frequently as a complication of diabetes mellitus.10-12 However, amputations are also

carried out for a number of other reasons, including congenital limb deficiency,

vascular insufficiency, cancer, and traumatic injury. Although amputees face major

physical, social, and emotional adjustments, adaptation varies widely between

individuals.13-14

Rybarcyzk, Nyenhuis, Nicholas, Cash and Kaiser15 note that anecdotal reports have

suggested a relationship between a negative body image and psychological

maladjustment to a leg amputation.16-18 An early study19 found that when the

projective Draw-A-Person Test was given to people who were rated as poorly

adjusted to their amputation, they