Prosthetic Categories

Improving Lower-Limb Amputees’ Daily Life With Active Lifestyle Interventions

    A lower-limb amputation negatively affects physical health, psychosocial well-being, and quality of life. So, to find solutions to improve daily life, researchers performed a systematic review of previous studies that investigated lifestyle interventions, such as supervised physical activity, meditation, and remote coaching.

     Lifestyle interventions, like physical activity and meditation, help improve lower-limb amputees' daily life.

    The data collection  

    The researchers combed through the studies published since the inception of three databases: CINAHL, Embase, and PubMed. Search terms were alcohol, amputation, diet, food intake, lifestyle, nutrition, physical activity, relaxation, smoking, and stress management.

    In total, the researchers retrieved 2,460 studies. But after removing duplicates and screening the title and abstract, only 13 studies were included in the systematic review—11 were focused on interventions to stimulate physical activity, and one was focused on stress management. Five were performed in North America, four in Asia, three in Europe, and one in Africa. The researchers didn’t find any study focusing on lifestyle interventions regarding alcohol use, nutrition, and smoking habits in people with a lower-limb amputation.

    The findings  

    Based on the results of the included studies, the physical fitness of people with a lower-limb amputation can be improved with one-legged endurance training of the sound side leg. Improving prosthetic limb usage through training the sound side leg also improved quality of life.

    Improving walking capacity called for different interventions, including telephone sessions for supervising behavioral changes, such as goal setting on home exercises, walking activity, and disease self-management. These supervised behavioral changes effectively increased gait speed, walking capacity, and daily walking behavior. However, the researchers found that such remote coaching sessions could have been more effective for older veterans.  

    The researchers also found some success with personalized exercise programs focusing on strength, balance, flexibility, and walking. These programs effectively improved walking ability and reduced falls, resulting in fewer injuries and lower economic costs.

    In two studies, some evidence was found for the contribution of lifestyle interventions to weight loss in people with lower-limb amputation. First, hip strength training reduces body mass in younger people with lower-limb amputation due to cancer, trauma, or congenital causes.

    Second, telephone-supervised physical activity and body weight management with goal setting focusing on self-monitoring, diet, and physical activity may decrease body weight in persons with limb loss due to nonvascular reasons. This has helped diminish negative effects on self-confidence and body image. The researchers noted that both interventions could be advised for overweight persons with lower-limb amputation.

    The researchers also found that stress management interventions are beneficial. A daily 15-minute meditation program focusing on muscle relaxation resulted in a significantly improved body image and mental condition in people with a lower-limb amputation due to diabetes mellitus.

    A short-term group intervention focused on understanding the consequences of the current and future situation and normalizing stress reactions was found to lower distress levels in people with a lower-limb amputation due to vascular disease or trauma. Based on these results, the researchers noted that these stress management interventions could be introduced in a rehabilitation program for people with lower-limb amputation.

    The bottom line  

    Through this systematic review, researchers found that lifestyle interventions focusing on physical activity and stress management effectively improve people’s physical and psychosocial functioning with lower-limb amputation.

    The researchers also noted that adding an education program on the consequences of amputation and coping strategies can effectively reduce stress levels, particularly in new amputees.

    Furthermore, the researchers emphasized the need for more research to evaluate the effectiveness of lifestyle interventions regarding alcohol use, nutrition, and smoking cessation in people with a lower-limb amputation.