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ORIJINAL ARAŞTIRMA

Alt Ekstremite Protezi Kullanan Hastalarda Amputasyon Düzeyinin Depresyon, Beden Imgesi Algisi ve Lökomotor Kapasitesine Etkisi
The Effect of the Level of Amputation on Depression, Body Image Perception and Locomotor Capacity in Patients Using Lower Extremity Prosthesis
Received Date : 19 Apr 2019
Accepted Date : 19 Jun 2019
Doi: 10.31609/jpmrs.2019-66556 - Makale Dili: EN
J PMR Sci. 2019;22(2):53-9
ÖZET
Amaç: Bu çalışmanın amacı; alt ekstremite protezi kullanan hastaların amputasyon seviyelerinin depresyon, beden imaj algısı ve lökomotor kapasitesi üzerine etkilerinin değerlendirilmesiydi. Gereç ve Yöntemler: Çalışmaya 62 hasta alındı. Hastaların demografik verileri ve klinik özellikleri kaydedildi. Hastalar amputasyon seviyesine göre transfemoral, transtibial amputasyon, ayak amputasyonu ve diz dezartikülasyonu olarak 4 gruba ayrıldı. Hastaların lökomotor kapasitelerini derecelendirmek için lökomotor beceri indeksi-5, beden imaj algısını ölçmek için ampute beden imaj ölçeği ve depresyon belirtilerini değerlendirmek için Beck depresyon ölçeği kullanıldı. Bulgular: Çalışmada ortalama yaşları 43,8±14,6 yıl olan (%74,2’si erkek %25,8’i kadın) 62 hasta mevcuttu. Amputasyon seviyesine göre ampute vücut imaj ölçeği skoru ve Beck depresyon ölçeği skoru ortalamaları arasında anlamlı fark olmadığı aksine lökomotor beceri indeksi-5 skoru ortalamaları açısından anlamlı fark olduğu saptandı. Lökomotor beceri indeksi skoru ortalamaları dört grupta karşılaştırıldığında diz dezartikülasyonlu ve transfemoral ampute, diz dezartikülasyonlu ve transtibial ampute, diz dezartikülasyonlu ve ayak amputasyonlu olgular arasında anlamlı fark olduğu saptandı. Diz dezartikülasyonlu olguların lökomotor becerisinin diğer gruplara göre anlamlı olarak daha düşük olduğu saptandı. Sonuç: Çalışmamızın sonucunda, diz dezartikülasyonlu hastalarda lökomosyon becerisi diğer amputasyon seviyelerine göre daha kötü tespit edilse de, depresyon ve beden imaj algısı açısından anlamlı fark tespit edilememiştir.
ABSTRACT
Objective: The aim of the study was to evaluate the effects of the amputation levels on depression, body image perception and locomotor capacity in patients using lower extremity prosthesis. Material and Method: In total, 62 patients were included in the study. The demographic data and clinical characteristics of the patients were recorded.The patients were divided into four groups depending on the level of amputation: transfemoral, transtibial, foot amputation and knee disarticulation. The locomotor capabilities index-5 was used to grade the locomotor capacity of the patients, amputee body image scale was used to measure the body image perception and beck depression inventory was used to assess the symptoms of depression. Results: The mean age of the 62 patients (74.2% male, 25.8% female) was 43.8±14.6 years. No significant difference was found between the mean scores for the amputee body image scale and Beck depression inventory scores that were determined according to the amputation levels, whereas a significant difference was observed with respect to the locomotor capabilities index-5 scores. When the mean the locomotor capabilities index-5 scores of the four amputee groups were compared, significant differences were found between scores of patients with knee disarticulation and transfemoral amputation, transtibial amputation, foot amputation. It was determined that patients with knee disarticulation had significantly lower locomotor capabilities than that of other amputation levels. Conclusion: In our study, although body image and locomotor capabilities were found to be lower among patients with knee disarticulation compared with other amputation levels, no significant difference was found in terms of depression and body image perception.
REFERENCES
  1. Karami G, Ahmadi Kh, Nejati V, et al. Better mental component of quality of life in amputee. Iran J Public Health. 2012;41:53-8.
  2. van der Sluis CK, Hartman PP, Schoppen T, et al. Job adjustments, job satisfaction and health experience in upper and lower limb amputees. Prosthet Orthot Int. 2009;33:41- 51. [Crossref]  [PubMed] 
  3. Aygan I, Tuncay I, Tosun N ve ark. Amputasyonlar: nedenleri ve seviyeleri (retrospektif klinik calisma). Artroplasti Artroskopik Cerrahi. 1999;10:179-83.
  4. Christensen J, Ipsen T, Doherty P, et al. Physical and social factors determining quality of life for veterans with lower-limb amputation(s): a systematic review. Disabil Rehabil. 2016:38:2345-53. [Crossref]  [PubMed] 
  5. Dillingham TR, Pezzin LE, MacKenzie EJ. Limb amputation and limb deficiency: epidemiology and recent trends in the United States. South Med J. 2002;95:875-83. [Crossref]  [PubMed] 
  6. Arwert HJ, van Doorn-Loogman MH, Koning J, et al. Residual-limb quality and functional mobility 1 year after transtibial amputation caused by vascular insufficiency. J Rehabil Res Dev. 2007;44:717-22. [Crossref]  [PubMed] 
  7. Hawamdeh ZM, Othman YS, Ibrahim AI. Assessment of anxiety and depression after lower limb amputation in Jordanian patients. Neuropsychiatr Dis Treat. 2008;4:627- 33. [Crossref]  [PubMed]  [PMC] 
  8. Franchignoni F, Orlandini D, Ferriero G, et al. Reliability, validity, and responsiveness of the locomotor capabilities index in adults with lower-limb amputation undergoing prosthetic training. Arch Phys Med Rehabil. 2004;85: 743-8. [Crossref]  [PubMed] 
  9. Safaz I, Yilmaz B, Goktepe AS ve ark. Turkish version of the amputee body image scale and relationship with quality of life. Bull Clin Psychopharmacol. 2010;20:79-83. [Crossref] 
  10. Gallagher P, Horgan O, Franchignoni F, et al. Body image in people with lower-limb amputation: a Rasch analysis of the Amputee Body Image Scale. Am J Phys Med Rehabil. 2007;86:205-15. [Crossref]  [PubMed] 
  11. Hisli N. A study on the validity of Beck Depression Inventory. Psikoloji Dergisi. 1988;6:118-22.
  12. McAnelly RD, Faulkner VW. Lower limb prostheses. In: Braddom RL, Buschbacher RM, Dumitru D, Johnson EW, Matthews D, Sinaki M, eds. Physical Medicine and Rehabilitation. Philadelphia: WB Saunders; 1996. p. 286-320.
  13. Esquenazi A. Amputation rehabilitation and prosthetic restoration. From surgery to community reintegration. Disabil Rehabil. 2004;26:831-6. [Crossref] 
  14. Esquenazi A, DiGiacomo R. Rehabilitation after amputation. J Am Podiatr Med Assoc. 2001;91:13-22. [Crossref]  [PubMed] 
  15. Penn-Barwell JG. Outcomes in lower limb amputation following trauma: a systematic review and meta-analysis. Injury. 2011;42:1474-9. [Crossref]  [PubMed] 
  16. Stirnemann P, Mlinaric Z, Oesch A, et al. Major lower extremity amputation inpatients with peripheral arterial insufficiency with special reference to the transgenicular amputation. J Cardiovasc Surg (Torino). 1987;2:152-8.
  17. Lim TS, Finlayson A, Thorpe JM, et al. Outcomes of a contemporary amputation series. ANZ J Surg. 2006;76:300-5. [Crossref]  [PubMed] 
  18. Met R, Janssen LI, Wille J, et al. Functional results after through-knee and above-knee amputations: does more length mean better outcome? Vasc Endovascular Surg. 2008;42:456-61. [Crossref]  [PubMed] 
  19. Alsancak S, Guner S. Why transfemoral amputation instead of knee disarticulation? Ankara Saglik Hizmetleri Dergisi. 2018;17:21- 4. [Crossref] 
  20. Rybarczyk BD, Nyenhuis DL, Nicholas JJ, et al. Social discomfort and depression in a sample of adults with leg amputation. Arch Phys Med Rehabil. 1992;73:1169-73.
  21. Darnall BD, Ephraim P, Wegener ST, et al. Depressive symptoms and mental health service utilization among persons with limb loss: results of a national survey. Arch Phys Med Rehabil. 2005;86:650-8. [Crossref]  [PubMed] 
  22. Asano M, Rushton P, Miller WC, et al. Predictors of quality of life among individuals who have a lower limb amputation. Prosthet Orthot Int. 2008;32:231-43. [Crossref]  [PubMed] 
  23. Siedel E, Lange C, Wetz HH, et al. Anxiety and depression after loss of a lower limb. Orthopade. 2006;35:1152-8. [Crossref]  [PubMed] 
  24. Cansever A, Uzun O, Yildiz C, et al. Depression in men with traumatic lower part amputation: a comparison to men with surgical lower part amputation. Mil Med. 2003;168:106-9. [Crossref]  [PubMed] 
  25. Mosaku KS, Akinyoola AL, Fatoye FO, et al. Psychological reactions to amputation in a sample of Nigerian amputees. Gen Hosp Psychiatry. 2009;31:20-4. [Crossref]  [PubMed] 
  26. Ide M. The association between depressive mood and pain amongst individuals with limb amputations. Eur J Trauma Emerg Surg. 2011;37:191-5. [Crossref]  [PubMed] 
  27. Rybarczyk B, Nyenhuis DL, Nicholas JJ, et al. Body image, perceived social stigma, and the perception of psychological adjustment to leg amputation. Rehabil Psychol. 1995;40:95-110. [Crossref] 
  28. Atay IM, Turgay O, Atay T. The prevalence of prosthesis use with the effects on body image, depression, anxiety and self-esteem in lowerextremity amputations. Turk J Phys Med Rehab. 2014;60:184-8. [Crossref]