Patient satisfaction following lower-limb amputation: the role of gait deviation.

Abstract

Patient satisfaction is an important measurement in healthcare for administrators, clinicians and patients. This study investigated the role of gait deviation in patient satisfaction following lower-limb amputation and prosthesis prescription. A cross-sectional study was done. Twenty community-based unilateral lower-limb amputees, 12 transtibial and 8 transfemoral, were recruited from support groups. Participants completed the prosthesis evaluation questionnaire (PEQ) with embedded satisfaction-related questions, the timed-up-and-go test and the six-minute walk test, and also underwent quantitative three-dimensional analysis. Kinematic deviation was summarized using the gait profile score (GPS). Satisfaction levels were generally high (median 80 + /100). Sociodemographic variables did not correlate significantly with any of the satisfaction measures (-0.35 ≤ r ≤ 0.54). Satisfaction correlated strongly with the PEQ scales, particularly ambulation, prosthetic utility, frustration, perceived response and social burden (r ≥ 0.70). By contrast, the relationships between satisfaction and performance-based outcome measures were not significant (-0.45 ≤ r ≤ 0.43), and the GPS did not correlate with any satisfaction measures (-0.23 ≤ r ≤ 0.15). In this study of high functioning amputees, gait deviation was unimportant to the amputee, while self-reported functional ability and attitudes toward the prosthesis were the strongest correlates of satisfaction following lower-limb amputation. For the high functioning individuals with lower-limb amputation in this study, gait deviation was not a significant correlate of patient satisfaction. RESULTS suggest that improving self-perceived functional ability and attitudes toward the prosthesis, rather than minimizing gait deviation, will improve patient satisfaction.