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New Study Quantifies Impact of Lower-Limb Amputation on Body Image

Posted April 1, 2014

Nearly two million Americans currently live with limb loss, according to the Amputee Coalition, and that number is expected to double by 2050. While the physical impact of limb loss is relatively well understood, the psychological impact is much more challenging to quantify.

Researchers in Austria are hoping to change that with what they are calling “the first and largest study assessing…two major components of aesthetic perception in combination in lower-limb amputees.”

Study participants, comprising 149 unilateral or bilateral amputees and 149 age- and gender-matched controls, were asked to fill out a 118-item questionnaire to assess their body image, self-esteem, and quality of life (QoL). Body image was assessed using the Multidimensional Body-Self Relations Questionnaire (MBSRQ), self-esteem was measured using the Rosenberg Self-Esteem (RSE) scale, and QoL was assessed using the SF-36 Health Survey. Participants were required to be at least 18 years old and to have undergone unilateral or bilateral lower-limb amputation within six months of participating in the study. Individuals with congenital limb loss or amputees who had used a prosthetic limb prior to the study were excluded from consideration.

The results indicate that patients with lower-limb amputation have lower levels of body image perception and QoL compared to the control group, but lower-limb amputation alone does not significantly impact an individual’s self-esteem level.

“Unilateral lower-limb amputees had a significantly lower MBSRQ score compared with controls, indicating that a lower-limb amputation decreases body image perception significantly,” the authors wrote. However, they also reported, “lower-limb amputees who performed physical activities regularly had a higher body image.”

“The loss of a body part has an enormous impact on QoL,” the authors continued. Lower-limb amputees reported higher levels of bodily pain and lower levels of physical functioning, social function, mental health, and vitality than the control group on the SF-36 Health Survey.

While there was no significant difference on the RSE scale in unilateral lower-limb amputees compared to controls, “phantom pain, if present” did have a significant impact on self-esteem. “Unilateral lower-limb amputees with phantom pain sensation had significant differences in health evaluation, bodily pain, role limitation due to emotional problems, physical functioning, general health, mental health…the RSE scale, and the SF-36 (all subscales combined),” the authors noted, adding that 63 percent of the amputee study participants presented with at least moderate levels of phantom limb pain sensation.

Results of the study, “Body Image and Self-Esteem in Lower-Limb Amputees,” were published March 24 in PLOS ONE.

To read the study, visit the PLOS ONE website.