How Lower Limb Amputation Shapes Patient Quality of Life? Systematic Review
Keywords:
amputation lower limb, anxiety, HRQoL, psychological adjustment, quality of lifeAbstract
Amputation substantially affects both physical and psychological well-being, bringing considerable changes to patients' lives. The present systematic review sought to examine QoL and Health-Related Quality of Life (HRQoL) among individuals who underwent lower limb amputation. A comprehensive literature search was performed across PubMed, Scopus, and ScienceDirect databases using keywords including "Lower Extremity Amput*" OR "Lower Limb Amput*" AND "Quality of Life" OR "Psychologist*". Studies published between 2018 and 2023 addressing QoL/HRQoL in lower limb amputee populations were considered for inclusion. Article selection and analysis followed the PRISMA protocol. The search identified 577 articles in total, of which 14 met the eligibility criteria and were incorporated into the review. The findings consistently showed that lower limb amputees experienced reduced QoL/HRQoL, with notable recovery observed from at least six months post-amputation onward. Key drivers of this recovery included emotional resilience, motivational factors, availability of social support, and individual patient attributes.
References
Abdel Rahim, A., Tam, A., Holmes, M., & Mittapalli, D. (2022). The effect of amputation level on patient mental and psychological health, prospective observational cohort study. Annals of Medicine and Surgery (2012), 84, 104864. https://doi.org/10.1016/j.amsu.2022.104864
Abouammoh, N., Aldebeya, W., & Abuzaid, R. (2021). Experiences and needs of patients with lower limb amputation in Saudi Arabia: a qualitative study. Eastern Mediterranean Health Journal = La Revue de Sante de La Mediterranee Orientale = Al-Majallah Al-Sihhiyah Li-Sharq Al-Mutawassit, 27(4), 407–413. https://doi.org/10.26719/emhj.20.124
Calabrese, L., Maffoni, M., Torlaschi, V., & Pierobon, A. (2023). What Is Hidden behind Amputation? Quanti-Qualitative Systematic Review on Psychological Adjustment and Quality of Life in Lower Limb Amputees for Non-Traumatic Reasons. Healthcare (Basel, Switzerland), 11(11). https://doi.org/10.3390/healthcare11111661
Costa, V. de O., Teixeira, F. M., Lopes, T. M., Gomide, H. P., Clemente, P. C., & Moreira, D. (2021a). Phantom sensation and quality of life among patients with lower-limb amputations in the region of Juiz de Fora, Minas Gerais: a cross-sectional study. Dementia & Neuropsychologia, 15(2), 275–280. https://doi.org/10.1590/1980-57642021dn15-020016
Costa, V. de O., Teixeira, F. M., Lopes, T. M., Gomide, H. P., Clemente, P. C., & Moreira, D. (2021b). Phantom sensation and quality of life among patients with lower-limb amputations in the region of juiz de fora, minas gerais a cross-sectional study. Dementia e Neuropsychologia, 15(2), 275–280. https://doi.org/10.1590/1980-57642021dn15-020016
Crocker, R. M., Palmer, K. N. B., Marrero, D. G., & Tan, T.-W. (2021). Patient perspectives on the physical, psycho-social, and financial impacts of diabetic foot ulceration and amputation. Journal of Diabetes and Its Complications, 35(8), 107960. https://doi.org/https://doi.org/10.1016/j.jdiacomp.2021.107960
Cruz Silva, J., Constâncio Oliveira, V., Lima, P., Correia, M., Moreira, M., & Anacleto, G. (2021). Change in Domains that Influence Quality of Life after Major Lower Limb Amputation in Patients with Peripheral Arterial Disease. Annals of Vascular Surgery, 75, 179–188. https://doi.org/10.1016/j.avsg.2021.01.082
Gil-Lacruz, M., Gil-Lacruz, A. I., & Gracia-Pérez, M. L. (2020). Health-related quality of life in young people: The importance of education. Health and Quality of Life Outcomes, 18(1), 1–13. https://doi.org/10.1186/s12955-020-01446-5
Hando, D. J., Byomuganyizi, M. J., Ngendahayo, J. B., Khamisi, R. H., Kivuyo, N. E., Kunambi, P. P., Mutajwaha, J. L., Mushi, G. R., Kitua, D. W., & Mwanga, A. H. (2023). Factors Influencing the Health-Related Quality of Life Among Lower Limb Amputees: A Two-Center Cross-Sectional Study. The East African Health Research Journal, 7(1), 121–126. https://doi.org/10.24248/eahrj.v7i1.718
Hando, D. J., Byomuganyizi, M. J., Ngendahayo, J. B., Ramadhani, H., Kivuyo, N. E., Kunambi, P. P., Mutajwaha, J. L., Mushi, R., Kitua, D. W., & Mwanga, A. H. (2023). Factors Influencing the Health-Related Quality of Life among Limb Amputees: A Two-Center Cross-Sectional Study. East African Health Research Journal, 7(1), 121–126. https://doi.org/10.24248/eahrj.v7i1.718
Juzwiszyn, J., Łabuń, A., Tański, W., Szymańska-Chabowska, A., Zielińska, D., & Chabowski, M. (2022). Acceptance of illness, quality of life and nutritional status of patients after lower limb amputation due to diabetes mellitus. Annals of Vascular Surgery, 79, 208–215. https://doi.org/10.1016/j.avsg.2021.07.023
Kablan, N., & Tatar, Y. (2020). An investigation of quality of life related to prosthesis in syrian refugee lower extremity amputees. Turkish Journal of Physiotherapy and Rehabilitation, 31(3), 298–306. https://doi.org/10.21653/tjpr.618199
Khan, M. J. (2018). Family Relations, Quality Of Life And Post Traumatic Stress Among Family Relation, Quality of Life, and Post-Traumatic Stress. August, 125–130.
Kizilkurt, O. K., Kizilkurt, T., Gulec, M. Y., Giynas, F. E., Polat, G., Kilicoglu, O. I., & Gulec, H. (2020). Quality of life after lower extremity amputation due to diabetic foot ulcer: The role of prosthesis-related factors, body image, self-esteem, and coping styles. Dusunen Adam - The Journal of Psychiatry and Neurological Sciences, 33(2), 109–119. https://doi.org/10.14744/DAJPNS.2020.00070
Kolivand, S., Jahantabi-Nejad, S., & Hamedi, D. (2023). The Relationship between Quality of Life and Social Support in People with Diabetes with Lower Limb Amputation. Journal of Modern Rehabilitation, 17(3), 298–305. https://doi.org/10.18502/jmr.v17i3.13071
Maciver, M., Dixon, D., & Powell, D. (2023). Quality of life in young people with limb loss: a systematic review. Disability and Rehabilitation, 0(0), 1–12. https://doi.org/10.1080/09638288.2023.2270908
Matos, D. R., Naves, J. F., & Arajuo, D. (2020). Quality of life of patients with lower limb amputation with prostheses. Estudos de Psicologia (Campinas), 37. https://doi.org/10.1590/1982-0275202037e190047
Mcdonald, S., Sharpe, L., & Blaszczynski, A. (2014). The psychosocial impact associated with diabetes-related amputation. Diabetic Medicine, 31(11), 1424–1430. https://doi.org/10.1111/dme.12474
Melo, V. H. De, Sousa, R. A. L. de, Improta-Caria, A. C., Nunes, M. A. P., De Melo, V. H., De Sousa, R. A. L., Improta-Caria, A. C., Nunes, M. A. P., Melo, V. H. De, Sousa, R. A. L. de, Improta-Caria, A. C., & Nunes, M. A. P. (2021). Physical activity and quality of life in adults and elderly individuals with lower limb amputation. Revista Da Associacao Medica Brasileira (1992), 67(7), 985–990. https://doi.org/10.1590/1806-9282.20210382
Migaou, H., Kalai, A., Hassine, Y. H., Jellad, A., Boudokhane, S., & Frih, Z. B. S. (2019). Quality of Life Associated Factors in a North African Sample of Lower Limbs Amputees. Annals of Rehabilitation Medicine, 43(3), 321–327. https://doi.org/10.5535/arm.2019.43.3.321
Monnaatsie, M., Biddle, S. J. H., Khan, S., & Kolbe-Alexander, T. (2021). Physical activity and sedentary behaviour in shift and non-shift workers: A systematic review and meta-analysis. Preventive Medicine Reports, 24, 101597. https://doi.org/https://doi.org/10.1016/j.pmedr.2021.101597
Ng, S. S., Naing, L., Idris, F. I., & Pande, K. C. (2020). What is the quality of life of transtibial amputees in brunei darussalam? Malaysian Orthopaedic Journal, 14(2), 39–46. https://doi.org/10.5704/MOJ.2007.009
Page, M. J., Moher, D., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-wilson, E., Mcdonald, S., … Prisma, M. (2021). RESEARCH METHODS AND REPORTING PRISMA 2020 explanation and elaboration : updated guidance and exemplars for reporting systematic reviews review findings . The Preferred. https://doi.org/10.1136/bmj.n160
Pedras, S., Vilhena, E., Carvalho, R., & Pereira, M. G. (2020). Quality of Life Following a Lower Limb Amputation in Diabetic Patients: A Longitudinal and Multicenter Study. Psychiatry (New York), 83(1), 47–57. https://doi.org/10.1080/00332747.2019.1672438
Pereira, M. G., Ramos, C., Lobarinhas, A., Machado, J. C., & Pedras, S. (2018). Satisfaction with life in individuals with a lower limb amputation: The importance of active coping and acceptance. Scandinavian Journal of Psychology, 59(4), 414–421. https://doi.org/10.1111/sjop.12444
Pran, L., Baijoo, S., Harnanan, D., Slim, H., Maharaj, R., & Naraynsingh, V. (2021). Quality of Life Experienced by Major Lower Extremity Amputees. Cureus, 13(8), e17440. https://doi.org/10.7759/cureus.17440
Roșca, A. C., Baciu, C. C., Burtăverde, V., & Mateizer, A. (2021). Psychological Consequences in Patients With Amputation of a Limb. An Interpretative-Phenomenological Analysis. Frontiers in Psychology, 12(May). https://doi.org/10.3389/fpsyg.2021.537493
Sarroca, N., Valero, J., Deus, J., Casanova, J., Luesma, M. J., & Lahoz, M. (2021). Quality of life, body image and self-esteem in patients with unilateral transtibial amputations. Scientific Reports, 11(1). https://doi.org/10.1038/s41598-021-91954-1
Torbjörnsson, E., Ottosson, C., Blomgren, L., Boström, L., & Fagerdahl, A. M. (2017). The patient’s experience of amputation due to peripheral arterial disease. Journal of Vascular Nursing, 35(2), 57–63. https://doi.org/10.1016/j.jvn.2016.11.002
Van der Schans, C. P., Geertzen, J. H. B., Schoppen, T., & Dijkstra, P. U. (2003). Phantom pain and health-related quality of life in lower limb amputees. Journal of Pain and Symptom Management, 24(4), 429–436. https://doi.org/10.1016/S0885-3924(02)00511-0
Yusof, N. M., Ahmad, A. C., Sulong, A. F., Adnan, M. J. M., Rahman, J. A., & Musa, R. (2019). Quality of life of diabetes amputees following major and minor lower limb amputations. Medical Journal of Malaysia, 74(1), 25–29. https://www.scopus.com/inward/record.uri?eid=2-s2.0-85062584080&partnerID=40&md5=3adba2077f22518eadde40adba6c8bb0
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Nurul Hidayati, Geladis Titanik, Andi Safutra Suraya, Trihaningsih Puji Astuti, Norwinda Norwinda, Fariha Nurlia
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
