Social and community participation following traumatic lower limb amputation: an exploratory qualitative study

Purpose: To explore barriers and facilitators to social and community participation experienced by people following traumatic lower limb amputation (LLA). Methods: An exploratory qualitative study was conducted with nine adults with traumatic LLA in Victoria, Australia. Participants were a minimum of 18 months post amputation. Interview data was analysed using thematic analysis. Results: Participants referenced the inaccessibility of the built environment and physical challenges associated with prosthetic mobility as barriers to participation. Chronic and complex health concerns due to their injuries resulted in physical and emotional distress for some, further limiting their social and community engagement. Participants highlighted the benefit of peer-support networks and the value of supportive community groups in assisting the transition to their pre-amputation family, work and social roles. Participants also felt that a strong, positive attitude and being self-motivated were important to aid in their return to social and community participation. Conclusion: People following traumatic LLA experience a number of physical, psychological and environmental challenges to participation. The role of peer-support networks, community groups and personal attitudes are important facilitators to assist a return to family, work and life roles. The findings of this study have informed the development of recommendations to guide clinical practice.IMPLICATIONS FOR REHABILITATION Peer-support groups for people following traumatic lower limb amputation (LLA) may assist to improve their long-term adjustment to disability and community participation Retraining skills in an individual’s own community should be considered when planning community-based therapy services for people following traumatic LLA. Ongoing psychosocial support including strategies to develop self-efficacy and positive mindset may improve social and community participation Regular medical and allied health reviews can be beneficial to promote early intervention for any complications that arise to minimise time off prosthesis.