Study: Mental health issues, drug and alcohol abuse key factors in prosthesis rejection

NEW ORLEANS — A speaker here at the American Academy of Orthotists and Prosthetists Annual Meeting and Scientific Symposium took a look into the mental health of amputees in outpatient clinics and the role it plays in prosthetic rehabilitation.

Tiffany A. Ryan, OTR, MOT, and a team of researchers at Advanced Arm Dynamics, conducted the Wellness Inventory, a streamlined screening for mental health that identifies obstacles, such as pain, depression, substance abuse and posttraumatic anxiety after limb loss.


Tiffany A. Ryan


A total of 57 data sets were analyzed. The final cohort was 59.6% male at an average age of 43 years. Nearly 76% reported trauma as cause of amputation; 7% of the patients were congenital and 17.5% of the patients were bilateral amputees.

Researchers found that 20.8% of the patients studied had restricted activity and 14% of the patients experienced depression after amputation.

Pain was the biggest factor in reduced quality of life, as 52.7% said it interfered with normal activity. Poor fit, training, function, aesthetics, physiological and social challenges were also factors in reduced quality of life.

As a result, 17.6% of the patients studied had post-traumatic anxiety, 30.4% misused alcohol and 15.8% misused prescription or street drugs in the past year.

Ryan said the goal moving forward is to identify potential obstacles at initial contact, promote patient understanding, inform prosthetic rehabilitation planning and facilitate provision of mental health services.

Clinical services that assist in pain management and promote personal resilience are critical in improving adjustment and quality of life, she said.

“Our patients need us throughout the rehabilitation process. Things like the Wellness Inventory show evidenced-based outcomes that translate scientific knowledge into clinical benefits.

“This could create a new conversation a part of our relationship…so the patient does not totally give up and put their prosthesis in a closet.” – by Shawn M. Carter


Ryan T. Paper F3. Presented at: American Academy of Orthotists and Prosthetists Annual Meeting and Scientific Symposium; Feb. 18-21, 2015; New Orleans.

Disclosure: Advanced Arm Dynamics has not received payment from product manufacturers, individuals or other entities included in presentation.

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