Health-related quality of life and functionality in patients with unilateral trans-tibial amputations in a tertiary care hospital, South India

Introduction: Amputation leads to disability and loss of mobility. This study focuses on the short-term recovery, especially early functionality gains and quality of life (QOL) improvements and how rehabilitation practices, particularly, timely fitting of prostheses and how educational status in specific, influence rehabilitation success. Objectives: To assess the health-related quality of life (HRQOL) and functionality at 1, 3, and 6 months after unilateral trans-tibial amputation in a tertiary care hospital, South India. Methods: A longitudinal cohort study was conducted among 76 participants over 1.5 years using the tools, Research and Development (RAND-36) survey to measure HRQOL and Amputee Mobility Predictor (AMP), to assess functionality. Inclusion criteria: 1) Age-18–75 years; 2) unilateral trans-tibial amputees; and 3) operated at the given setting. Results: Diabetic foot was the leading cause for amputation. At the end of 6th month, there was significant improvement ( p < 0.05) in all parameters with confidence interval of 95%, QOL (95.8–103.9), and functionality (10.1–20.8). In comparison to nonusers, prosthetic users had significant improvements by the 6th month, w.r.t HRQOL (106.3) and AMP scores (26.1); nonusers (102.2 and 17.2, respectively). Amputees with higher education had significantly higher, HRQOL (106.1), AMP (26.9) scores, Medicare Functional Classification Levels (K2 and K3), and prosthesis usage rates (73.7%). Approximately 55.6% prosthetic users returned to work, vs. 32.1% nonusers. Conclusion The HRQOL and functionality improved remarkably by the 6th month. Prosthesis has a positive impact on functionality, QOL, and return to work. Education is a significant determinant of prosthesis adoption and rehabilitation success.