Psychosocial Factors of Wearing a Prosthetic

October 20, 2014 | posted in: Health and Wellness, Mental Health | by

Life after losing a limb and learning to rely on a prosthetic involves changes in the individual on psychological, physical and social levels. In the process of adjusting to life after the trauma of such an event, there are consequences in terms of psychosocial functioning as the individual manages the loss itself. Additionally, emotional issues and learning how to relate to others with a new physical expression of the self can be challenging.

Life After Medical Trauma
Though most believe post traumatic stress disorder (PTSD) occurs after a crime, war or natural disaster, medical trauma can also cause PTSD. The Diagnostic and Statistical Manual of Mental Disorders describes PTSD as a condition following a trauma in which “an individual who has been exposed to a traumatic event develops anxiety symptoms, re-experiencing of the event, and avoidance of stimuli related to the event.” After loss of a limb, which is a trauma itself, as well as the event causing the loss, there is reason for the individual with a new prosthetic to be vulnerable to developing this disorder. Increased social support and surrounding oneself with others becoming accustomed to new physical circumstances may help ward off PTSD and increase positive psychosocial functioning.
Managing Phantom Pain
An issue that affects the daily life of many prosthetics wearers is a phenomenon called phantom pain. This occurs when the individual experiences pain, tingling or itching where the limb used to be. Since no relief can be found, work and social interaction can be difficult. In 2008, doctors in the United Kingdom published a study in the journal “Complimentary Therapies in Clinical Practice,” looking at reflexology as a way to help ease phantom pain. Reflexology is a kind of therapy in which the patient copies the movements of the therapist, mimicking both limbs, even if one is missing. The idea is that the brain will process both sets of movements, and relief will then occur at the cortical level. In this study, the scientists found that the combination of reflexology treatment with a therapist, teaching and self-treatment was effective in significantly reducing phantom limb pain. When an individual takes control of his or her own treatment, psychosocial adjustment may be eased.

Relating to Others
There are also issues involved in relating to others socially after such an extreme physical change. In 2008, researchers in Glasgow investigated how physical activity affects quality of life in lower-limb amputees who were receiving prosthetics-based rehabilitation. The participants answered questions on two surveys, the Trinity Amputation and Prosthetic Experience Scales and the World Health Organization Quality-of-Life Scale. These scales ask about psychological, physical and general psychosocial adjustment with a prosthetic. The study results, which were published in the journal “Prosthetics and Orthotics International,” found that patients were focused most on physical ability as it related to socialization and relationships. Such data suggests that changes in activity level may directly affect the ability to relate to others, and new outlets for relationships must be created.
Creating a Comprehensive Rehabilitation Plan
Following an injury or illness that results in such an extreme change, the individual and his or her family need to work together to create a comprehensive plan for rehabilitation that includes emotional support, physical therapy and training, possible private therapy and socialization.

• “The Diagnositic and Statistical Manual of Mental Disorders, 4th Edition, Revised;” The American Psychiatric Association; 1994.
• “Complimentary Therapies in Clinical Practice;” Reflexology treatment for patients with lower limb amputations and phantom Limb Pain– An Exploratory Pilot Study;” Brown CA, et al; February, 2008.
• “Prosthetics and orthotics international;” Physical activity and quality of life: A Study of a Lower-limb Amputee Population;” Deans SA, et al; Februaru; 2008.

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