Disparities in functional recovery after dysvascular lower limb amputation are associated with employment status and self-efficacy

Abstract

Purpose

Employment status is considered a determinant of health, yet returning to work is frequently a challenge after lower limb amputation. No studies have documented if working after lower limb amputation is associated with functional recovery. The study's purpose was to examine the influence of full-time employment on functioning after lower limb amputation.

Methods

Multisite, cross-sectional study of 49 people with dysvascular lower limb amputation. Outcomes of interest included performance-based measures, the Component Timed-Up-and-Go test, the 2-min walk test, and self-reported measures of prosthetic mobility and activity participation.

Results

Average participant age was 62.1 ± 9.7 years, 39% were female and 45% were persons of color. Results indicated that 80% of participants were not employed full-time. Accounting for age, people lacking full-time employment exhibited significantly poorer outcomes of mobility and activity participation. Per regression analyses, primary contributors to better prosthetic mobility were working full-time (R² ranging from 0.06 to 0.24) and greater self-efficacy (R² ranging from 0.32 to 0.75).

Conclusions

This study offers novel evidence of associations between employment and performance-based mobility outcomes after dysvascular lower limb amputation. Further research is required to determine cause-effect directionalities. These results provide the foundation for future patient-centered research into how work affects outcomes after lower limb amputation.

IMPLICATIONS FOR REHABILITATION

• Lower limb amputation can pose barriers to employment and activity participation, potentially affecting the quality of life.

• This study found that the majority of people living with lower limb amputation due to dysvascular causes were not employed full-time and were exhibiting poorer prosthetic outcomes.

• Healthcare practitioners should consider the modifiable variable of employment when evaluating factors that may affect prosthetic mobility.

• The modifiable variable of self-efficacy should be assessed by healthcare professionals when evaluating factors that may affect prosthetic mobility.

Keywords:

• Amputation
• lower extremity
• employment
• mobility
• disparities

Disclosure statement

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

Data availability statement

The datasets generated during and/or analyzed during the current study are available from the corresponding author upon reasonable request.

Additional information

Funding

This research was supported in part by the National Institute on Minority Health and Health Disparities of the National Institutes of Health Under Award Number NIMHD (U54MD012393), Florida International University Research Center in Minority Institutions. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.