The impact of amputation extends beyond the physical loss, significantly affecting psychological well-being. Studies have shown correlations between amputation and increased rates of depression, anxiety, social discomfort, and body image issues (Horgan & MacLachlan, 2004). Exercise has emerged as a non-pharmacological treatment for depression, with effects on brain chemistry similar to those of antidepressants (Trivedi et al., 2011). Despite this, much of the literature focuses on the negative aspects of amputation (Desmond & MacLachlan, 2002). This review aims to explore the psychological benefits of physical activity for individuals with lower limb amputation, focusing on body image and quality of life.
Methods
A literature review was conducted using keywords such as "amputation or amputee," "physical activity or exercise," and "psychological, psychosocial, quality of life, depression, anxiety, social discomfort, and body image." Out of 34 articles reviewed, two were found to be particularly relevant: "Effect of Participation in Physical Activity on Body Image of Amputees" by Wetterhahn, Hanson, and Levy (2002) and "Physical Activity and Quality of Life: A Study of a Lower-Limb Amputee Population" by Deans, McFadyen, and Rowe (2008). Exclusion criteria included non-English articles, case studies/reviews/editorials, non-relevance, and validation of an instrument
Results
Body Image
Wetterhahn, Hanson, and Levy (2002) explored the relationship between physical activity and body image in 24 active and 32 minimally active lower limb amputees. Using the Multidimensional Body Self-Relation Questionnaire (MBSRQ) and Amputee Body Image Scale (ABIS), they found a statistically significant positive relationship between physical activity and body image. Active participants were defined as those engaging in at least 2 hours of aerobic activity per week in sessions of 20 minutes each.
Quality of Life
Deans, McFadyen, and Rowe (2008) investigated the impact of physical activity on perceived quality of life in 25 geriatric lower limb amputees. Utilizing the Trinity Amputation and Prosthetic Experience Scales (TAPES) and World Health Organization Quality of Life Scale (WHOQOL-Bref), they found a statistically significant but weak correlation. The study suggested that postoperative physiotherapy should include individualized exercise programs and emphasized the importance of increasing physical activity without compromising social interaction.
Discussion
Amputation can lead to anxiety, isolation, depression, and difficulty in accepting body image changes (Horgan & MacLachlan, 2004). Inactivity contributes to the deteriorating health of people with disabilities (Valliant, 1985). Physical activity has been shown to improve major depression (Trivedi, 2011). This review highlights the potential for physical activity to positively influence body image and quality of life in individuals with lower limb amputation.
Conclusion
The goal of returning patients to their previous activity levels may not always be the most appropriate approach. Kegel (1985) found that most amputees expressed interest in participating in sports and recreation. Physical activity can motivate the disabled population to reshape their lives positively (Valliant, 1985). With individualized exercise programs, patients can expect improvements in body image, self-esteem, and proprioception.
References
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Desmond and MacLachlan. JPO. 14(1), 19-22; 2004.
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Kegel BJ. Rehabil Res Dev Clin Suppl. 38:310-325, 1985.
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Trivedi MH, Greer TL, Church TS, Carmody TJ, Grannemann BD, Galper DI...Blair SN. J Clin Psych. 72(5), 677-684, 2011.
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Valliant PM, Bezzubyk I, Daley L, & Asu ME: Psychol Rep 1985;56:923-9.
Wetterhahn KA, Hanson C, & Levy CE. Am J Phys Med Rehabil. 81(3), 34-67, 2002.
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