Psychosocial Factors Influence Physical Activity after Dysvascular Amputation: A Convergent Mixed‐Methods Study

Background Physical function is a common target of rehabilitation intervention to improve disability and physical activity after dysvascular lower‐limb amputation (LLA); yet, the influence of psychosocial factors on physical activity is unclear. Objective To identify psychosocial factors with potent...

Full description

Saved in:
Bibliographic Details
Published in:PM & R 2021-07, Vol.13 (7), p.737-745
Main Authors: Miller, Matthew J., Morris, Megan A., Magnusson, Dawn M., Putnam, Kelly, Cook, Paul F., Schenkman, Margaret L., Christiansen, Cory L.
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Amputation, Surgical
Artificial Limbs
Disabled Persons
Exercise
Humans
Lower Extremity - surgery
Middle Aged
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background Physical function is a common target of rehabilitation intervention to improve disability and physical activity after dysvascular lower‐limb amputation (LLA); yet, the influence of psychosocial factors on physical activity is unclear. Objective To identify psychosocial factors with potential to influence clinically relevant measures of physical activity, physical function, and disability in light of participants' narratives. Design Convergent mixed‐methods. Setting General community. Participants Twenty participants with dysvascular LLA were enrolled if their most recent LLA was at least 1 year prior, they were ambulating independently with a prosthesis, and were between 45 and 88 years old. Intervention Not applicable. Main Outcome Measures Quantitative data included physical activity (activPAL; steps/d), physical function (Timed Up‐and‐Go; TUG), and disability (World Health Organization Disability Assessment Schedule 2.0; WHODAS 2.0). Qualitative data were collected via semistructured interviews. Results Higher steps/d was moderately correlated with better TUG time (r = −.58, P  .10). Qualitative analysis of interviews, using an inductive, team‐based, phenomenological approach, identified four themes: (1) perceptions of their prosthesis, (2) fear during mobility, (3) influence of LLA on life activities, and (4) positive outlook within social interactions. Mixed‐methods analysis used an iterative approach to interpret and describe how psychosocial factors influence physical activity in four exemplar cases. Conclusions Physical activity in people with dysvascular LLA results from an interaction among perceptions of their prosthesis, fear during mobility, influence of LLA on life activities, and positive outlook within social interactions. The overlapping nature of these themes suggests that interventions targeting psychosocial factors may be associated with improved physical activity, physical function, and subsequent disability after dysvascular LLA.
ISSN:1934-1482
1934-1563
DOI:10.1002/pmrj.12466