Rehabilitation experiences following major lower limb amputation due to complications of vascular disease: a UK qualitative study

Abstract

Purpose

Rehabilitation experiences of lower limb amputees with poorer physical health have not been fully explored. This study aimed to qualitatively explore experiences of rehabilitation amongst patients who had recently undergone amputation due to complications of vascular disease.

Methods

Semi-structured, face-to-face interviews were conducted with 14 patients participating in the PLACEMENT randomised controlled feasibility trial (ISRCTN: 85710690; EudraCT: 2016-003544-37), which investigated the effectiveness of using a perineural catheter for postoperative pain relief following major lower limb amputation. Framework analysis was used to identify key themes and compare participant data.

Findings

Three main themes and corresponding sub-themes were identified: (i) other patients as inspiration; (ii) other patients as competition; and (iii) imagined futures. Perceptions relating to other patients played a key role in rehabilitation, providing a source of motivation, support, and competition. Participants’ imagined futures were uncertain, and this was compounded by a lack of information and delays in equipment and/or adaptations.

Conclusions

Findings highlight the importance of fellow patients in supporting rehabilitation following lower limb amputation. Enabling contact with other patients should thus be a key consideration when planning rehabilitation. There is a clear unmet need for realistic information relating to post-amputation recovery, tailored to the needs of individual patients.

IMPLICATIONS FOR REHABILITATION

• There is a clear unmet need for patient information on rehabilitation following major lower limb amputation.

• Information about future mobility - particularly prosthesis use - should be realistic and individually tailored.

• The key role of fellow patients should be fully considered when planning post-amputation rehabilitation.

Keywords:

• Amputation
• rehabilitation
• qualitative research
• peripheral vascular disease
• interviews

Acknowledgements

We thank all the patients who gave up their time to participate in interviews, and all members of the PLACEMENT Feasibility study team. This work was supported by the Welsh Government through Health and Care Research Wales, via the Research for Patient and Public Benefit (RfPPB) scheme [reference number 1198]. The study was sponsored by Aneurin Bevan University Health Board, Newport, South Wales.

Disclosure statement

No potential conflict of interest was reported by the author(s).