Alavi Tahereh, Jalali Maryam, Farahmand Behshid, Babaee Taher
Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
PLoS One. 2025 Jul 14;20(7):e0327781. doi: 10.1371/journal.pone.0327781. eCollection 2025.
Quality of life is a crucial outcome in evaluating adjustment to prostheses for individuals with non-traumatic lower limb amputation (LLA). This study aimed to identify prostheses-related factors that predict the quality of life in people with non-traumatic, unilateral, transtibial amputation.
This cross-sectional study surveyed 168 people who have experienced non-traumatic, unilateral, transtibial amputations and use prosthesis. They completed the 12-item short-form (SF-12) health survey and the comprehensive lower limb amputee socket survey (CLASS). We did correlation analyses to explore relationships between the variables and quality of life, followed by multiple regression analyses to assess their impact on quality of life outcomes.
Quality of life had a strong positive association with comfort (r = 0.65, p = 0.001). There was a moderate positive association with socket stability (r = 0.46, p < 0.001) and suspension (r = 0.48, p = 0.001), as well as a weak positive association with appearance (r = 0.35, p = 0.001). In the final regression model, the comfort subscale of CLASS was the strongest predictor of quality of life (β = 0.51, p = 0.001).
This study highlights that prosthesis socket comfort is the primary prosthesis-related factor predicting the quality of life for individuals with non-traumatic, unilateral, transtibial amputation. Thus, rehabilitation should prioritize modifiable factors, especially optimal socket fitting. Identifying user needs is essential for better prosthesis use, as enhancements in other prosthetic components do not necessarily improve quality of life without considering socket comfort.
生活质量是评估非创伤性下肢截肢（LLA）患者对假肢适应情况的关键结果。本研究旨在确定与非创伤性、单侧、经胫骨截肢患者生活质量相关的假肢因素。
本横断面研究对168名经历过非创伤性、单侧、经胫骨截肢并使用假肢的患者进行了调查。他们完成了12项简短健康调查问卷（SF - 12）和综合下肢截肢者接受腔调查问卷（CLASS）。我们进行了相关性分析以探讨变量与生活质量之间的关系，随后进行多元回归分析以评估它们对生活质量结果的影响。
生活质量与舒适度呈强正相关（r = 0.65，p = 0.001）。与接受腔稳定性（r = 0.46，p < 0.001）和悬吊性（r = 0.48，p = 0.001）呈中度正相关，与外观呈弱正相关（r = 0.35，p = 0.001）。在最终回归模型中，CLASS的舒适度分量表是生活质量的最强预测因子（β = 0.51，p = 0.001）。
本研究强调，对于非创伤性、单侧、经胫骨截肢患者，假肢接受腔舒适度是预测生活质量的主要假肢相关因素。因此，康复应优先考虑可改变的因素，尤其是优化接受腔适配。识别用户需求对于更好地使用假肢至关重要，因为在不考虑接受腔舒适度的情况下，其他假肢部件的改进不一定能提高生活质量。
