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Healthcare providers urged to rethink treatment for female amputees

Women with limb loss have unique physical and psychosocial needs, meaning providers treating this population must adapt their healthcare delivery approach, says new research presented at Physiatry ’23, the Association of Academic Physiatrists (AAP) annual meeting.

There is a growing population of women with limb loss, yet limited research is available to provide evidentiary support for clinical decision-making in this demographic. To investigate the unique impact of limb loss on women, including physical and psychosocial needs, a group of researchers from the U.S. Department of Veterans Affairs (VA) and Department of Defense (DoD) healthcare systems and private sector administered an online needs assessment to female amputees.

“This lack of research presents a significant challenge for clinicians and physicians to address the needs of women with limb loss that may vary from men,” says Dr Roxanne Disla, an occupational therapist at the James J. Peters VA Medical Center in the Bronx, N.Y., and the study’s presenting author. “Furthermore, male structure and biomechanics tend to be the base for most prosthetic devices. As a result, women with limb loss tend to face significant challenges such as ill-fitting prostheses, skin issues and an increased risk of other health problems.”

In the new study, a convenience sample of 115 female and 93 male amputees completed the online needs assessment consisting of a bank of existing limb loss-and non-limb loss-specific surveys, which were categorized around domains of general health, quality of life, prosthetic use/needs, psychosocial health and behaviours, and body image. These surveys were supplemented with written items to ensure adequate coverage of relevant domains.

The researchers discovered that women with limb loss reported worse residual limb health compared to men, but had significantly fewer activity restrictions, while women also reported less satisfaction with the usefulness/reliability of their prosthesis than men. The researchers also found that women with limb loss were less satisfied with appearance compared to men, reported less ease in social situations, higher anxiety and depression, and worse body image perception than men.

Preliminary analyses indicates that women with limb loss have unique physical and psychosocial needs, thus challenging providers for women with limb loss to evolve healthcare delivery and research practices, as well as work jointly with industry in order to meet the unique needs of this population, the researchers concluded.

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