Greensboro, N.C. — While studies have shown female amputees have unique needs in terms of rehabilitation, prosthetic components and the psychological impact of amputation, more research is needed to fully determine the ways in which female amputees differ from male amputees, according to a presentation at the Amputee Coalition National Conference, here.
Male amputees are still the default for most studies and for the creation of most prostheses, components and accessories, according to Billie J. Randolph, PT, PhD, and Andrea Crunkhorn, DPT, both of the U.S. Department of Defense’s Extremity Trauma and Amputation Center of Excellence.
Billie J. Randolph
Crunkhorn reported that in 2005, 25% of amputees were female. Of the 45% of amputations due to trauma, 19% were among women. In addition, because women compose 15% of active duty military personnel and 18% of U.S. Army National Guard/Reserves personnel, the percentage of female amputees is expected to increase. The military also recently did away with its artificial cap on female soldiers taking part in combat.
“The closer you are to direct combat, doing foot patrols, the more likely we are going to see a higher rate of women with amputation related to combat,” Crunkhorn said.
Studies have shown female veterans are at higher risk for post-traumatic stress disorder, sexual trauma, homelessness and unemployment. In addition, women with lower limb amputations face physical challenges, such as significantly higher risks for osteoarthritis and skin problems than men. Female amputees show significantly greater overall pain intensity than male amputees, but female amputees also have shown more tendency toward pain catastrophizing and the use of coping self-statements to handle pain.
Although female amputees report greater satisfaction with their prosthetists, they report less satisfaction with their prostheses and are less likely to be fit properly; this means women need to be more active in their own care, according to Randolph.
“You need to be outspoken with your prosthetist and with your physician. If you are not getting a good fit, we need to figure this out and not accept it, because [women] reject [their prostheses] more than men,” she said.
Randolph noted most equipment from O&P manufacturers are still designed for men. For example, she said, many women have to wear pediatric feet to maintain their foot size but cannot support these devices as women weigh more than children.
“I think clinicians need to understand they have to give special consideration to things like custom bracing, prosthetic components, sockets [and] seating systems,” she said.
In addition, she said, most studies of amputees include few women. She encouraged female amputees to volunteer for research.
“We need it,” she said. “We do not have enough evidence to make your needs known.” – by Amanda Alexander
Randolph BJ. Unique considerations for females with amputation. Presented at: Amputee Coalition National Conference; June 9-11, 2016; Greensboro, N.C.
Disclosures: Crunkhorn and Randolph report no relevant financial disclosures.