Lower extremity amputation (LEA) leads to reduced mobility and walking capacity. Contextual factors influencing activities of daily living and community participation in people with LEA vary in low-, middle-, and high-income countries. In the present study, we aimed to review contextual factors influencing function of people with LEA in low- to middleincome countries. A literature search for articles published between January 2000 and 2018 was carried out using PubMed, Google Scholar, and Cochrane reviews databases. In total, 27 relevant articles were identified and reviewed: 8 qualitative studies, 4 manuals and factsheets, 10 descriptive cross-sectional studies, 2 comparative studies and 1 survey.
Several external contextual factors were strongly linked with poor functional outcome, dissatisfaction, and participation restriction: lack of awareness and inadequate rehabilitation and prosthetic services; lack of social security systems; health insurance; poor quality and durability and high cost of prostheses; poor transport facilities; and level of education in low- to middle-income countries. Low income, inaccessible environment, and social stigma associated with amputation reduced functional outcome and community participation. Internal factors like poor coping strategies, negative self-esteem, old-age, female gender, and negative body image were linked with poor functional outcome, whereas strong family support improved participation of people with LEA.
Our review highlights a strong need to build greater awareness on rehabilitation measures following amputation and need for disability inclusive environment to promote community participation in low- to middle-income countries.
Lower extremity amputation (LEA) leads to reduced mobility and walking capacity. Contextual factors influencing activities of daily living and community participation in people with LEA vary in low-, middle-, and high-income countries. In the present study, we aimed to review contextual factors influencing function of people with LEA in low- to middleincome countries. A literature search for articles published between January 2000 and 2018 was carried out using PubMed, Google Scholar, and Cochrane reviews databases. In total, 27 relevant articles were identified and reviewed: 8 qualitative studies, 4 manuals and factsheets, 10 descriptive cross-sectional studies, 2 comparative studies and 1 survey.
Several external contextual factors were strongly linked with poor functional outcome, dissatisfaction, and participation restriction: lack of awareness and inadequate rehabilitation and prosthetic services; lack of social security systems; health insurance; poor quality and durability and high cost of prostheses; poor transport facilities; and level of education in low- to middle-income countries. Low income, inaccessible environment, and social stigma associated with amputation reduced functional outcome and community participation. Internal factors like poor coping strategies, negative self-esteem, old-age, female gender, and negative body image were linked with poor functional outcome, whereas strong family support improved participation of people with LEA.
Our review highlights a strong need to build greater awareness on rehabilitation measures following amputation and need for disability inclusive environment to promote community participation in low- to middle-income countries.