Change in Quality of Life after Rehabilitation in Cambodia among Adults with Lower Limb Amputation

Abstract

Objectives: This study aimed to describe the quality of life (QoL) of persons with lower limb amputations (LLAs) in Cambodia both before and after rehabilitation, and to identify predictor variables associated with increased QoL outcomes post-rehabilitation. Methods: A total of 164 participants with LLA from 7 physical rehabilitation centers (PRCs) across Cambodia completed the baseline assessment; however, only 125 participants (58% below- or through-knee amputations; 98% unilateral) completed the 3-month follow-up, with 39 participants lost to follow-up. Participants were interviewed using the Comprehensive Quality of Life Scale Adult questionnaire (which includes both objective and subjective scores). Baseline data were collected on the first day of admission at the PRC, following referrals from hospitals after the limb surgery. Follow-up data were gathered 3 months after discharge from rehabilitation. A paired t-test was used to assess the difference in QoL scores, and linear regression identified factors potentially associated with changes in QoL. Results: Our findings indicate that both objective and subjective QoL scores of persons with LLA increased significantly 3 months after rehabilitation (p <0.001). The absence of residual stump pain was significantly associated with higher QoL scores (p = 0.002). In contrast, a longer delay (>12 months) between amputation and receipt of rehabilitation services was associated with a smaller improvement in subjective QoL (p = 0.023). Conclusions: The findings suggest that early rehabilitation after amputation and the inclusion of effective pain management may be associated with better QoL outcomes; however, these approaches should be evaluated through further research to validate their impact.