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Aim: The study examined the relationships between psychological variables and sexual functioning in persons with lower limb amputations., Method: Sixty-five participants (n = 49 males, n = 16 females) with lower limb amputations completed a battery of self-report questionnaires regarding their current psychological well-being and their current sexual activity. Measures included the anxiety items on the Hospital Anxiety and Depression Scale, the Beck Depression Inventory - Second Edition, Body Image Quality of Life Inventory, Body Exposure Self-Consciousness during Intimate Situations and the Golombok-Rust Inventory of Sexual Satisfaction., Results: Half of all participants with lower limb amputations were not currently sexually active. Approximately 60% of those who were sexually active scored within the clinical range for overall sexual dysfunction. Overall levels of sexual dysfunction were associated with significantly higher levels of anxiety (r = 0.40, p < 0.005), depression (r = 0.41, p < 0.015) and body exposure self-consciousness during sexual activities (r = 0.56, p < 0.005). Body image self-consciousness during sexual activities was the strongest predictor of sexual dysfunction., Conclusions: Psychological challenges following limb loss are strongly associated with levels of sexual dysfunction. The study highlights the need for psychological and psychosexual assessment and intervention following limb loss to enhance sexual functioning and overall quality of life. Implications for Rehabilitation Only half of the participants with a lower limb amputation were sexually active. Over 60% of those who were sexually active reported clinical levels of sexual dysfunction. One third of the entire sample scored within the clinical range for depression and for anxiety. Depression, anxiety and body image issues were significantly associated with sexual dysfunction in the current sample of individuals with lower limb amputation. There is a need for psychosexual assessment following limb loss to ensure that appropriate and timely interventions are made available. Interventions that target the psychological factors related to sexual dysfunction are likely to improve overall quality of life for these individuals.

Purpose: The aim of this study is to adapt the Special Interest Group in Amputee Medicine (SIGAM) mobility scale to Turkish, and to test its validity and reliability in lower extremity amputees., Material and Methods: Adaptation of the scale into Turkish was performed by following the steps in American Association of Orthopedic Surgeons (AAOS) guideline. Turkish version of the scale was tested twice on 109 patients who had lower extremity amputations, at hours 0 and 72. The reliability of the Turkish version was tested for internal consistency and test-retest reliability. Structural validity was tested using the "scale validity" method. For this purpose, the scores of the Short Form-36 (SF-36), Functional Ambulation Scale (FAS), Get Up and Go Test, and Satisfaction with the Prosthesis Questionnaire (SATPRO) were calculated, and analyzed using Spearman's correlation test., Results: Cronbach's alpha coefficient was 0.67 for the Turkish version of the SIGAM mobility scale. Cohen's kappa coefficients were between 0.224 and 0.999. Repeatability according to the results of the SIGAM mobility scale (grades A-F) was 0.822. We found significant and strong positive correlations of the SIGAM mobility scale results with the FAS, Get Up and Go Test, SATPRO, and all of the SF-36 subscales., Conclusion: In our study, the Turkish version of the SIGAM mobility scale was found as a reliable, valid, and easy to use scale in everyday practice for measuring mobility in lower extremity amputees. Implications for Rehabilitation Amputation is the surgical removal of a severely injured and nonfunctional extremity, at a level of one or more bones proximal to the body. Loss of a lower extremity is one of the most important conditions that cause functional disability. The Special Interest Group in Amputee Medicine (SIGAM) mobility scale contains 21 questions that evaluate the mobility of lower extremity amputees. Lack of a specific Turkish scale that evaluates rehabilitation results and mobility of lower extremity amputees, and determines their needs, directed us to perform a study on this topic when we took the number of amputations performed in our country into consideration. SIGAM mobility scale is directed at rehabilitation specialists who are working in amputee medicine. Turkish version of this scale was found both reliable and valid in our study and hence it can be used in clinical practice and studies.

Objective: To explore how individuals experience and perceive the use of assistive technologies following lower limb loss., Design: Cross-sectional qualitative interview design., Patients: Thirty individuals with lower limb amputation were recruited from a multi-disciplinary rehabilitation programme (26 males and 4 females); comprising individuals with above-knee (n=16), below-knee (n=12) and bilateral (n=2) amputations. Patients were at least 15 months post-rehabilitation, at least 18 years old and spoke English., Methods: Semi-structured interviews were conducted via telephone or in person. Interview data were inductively thematically analysed by a researcher who had no previous contact with participants., Results: Three key themes were identified: "It didn't feel part of me" - Heightened awareness and experiences of distance from prostheses following lower limb loss; "Depending on others is really tough" - Independence through assistive technologies; and "I feel confident with this leg" - The value of prosthesis use following amputation., Conclusion: The findings demonstrate that individuals with lower limb loss perceive and experience assistive technologies to have uses in ways beyond their potential for functional restoration. They may also attribute meanings and values relating to such technologies that may influence their use. Ascertaining and being aware of individuals' experiences and perceptions of assistive technologies is important for lower limb loss rehabilitation.

Purpose: To examine the impact of residual limb osteomyelitis (RLO) on the rehabilitation of lower limb amputees., Method: Retrospective review of the case notes of patients with RLO. Information sought included details of amputation, clinical features of investigations for and management of RLO and its effect on rehabilitation., Results: There were seven transfemoral and three transtibial amputees. Indications for amputation were vascular disease in nine cases, trauma in one. In each case, delayed wound healing or residual limb pain prompted radiological, hematological and microbiological investigations. Average time between amputation and diagnosis was 187 days. One patient died before treatment commenced. Two transtibial amputees were treated with intravenous antibiotics while rehabilitating using pylons. The remaining seven transfemoral amputees required surgical intervention and intravenous antibiotics. Five achieved independent ambulation following modification to or replacement of the originally cast prosthesis, averaging 408 days between amputation and commencement of rehabilitation. Two patients have not engaged in rehabilitation., Conclusion: RLO delays rehabilitation and has significant financial implications, incurred by prolonged hospitalisation, radiological investigations and prosthetic modifications. RLO should be considered in any case of delayed wound healing or residual limb pain in amputees, as earlier diagnosis may reduce the time to commencement of rehabilitation and subsequent independent ambulation.

Aims: To examine the prevalence and impact of back pain (BP) and residual limb pain (RLP) in ambulatory lower limb amputees (LLAs)., Methods: Patients completed questionnaires regarding demographics, their amputation, occurrence of BP and RLP. Visual analogue scales assessed pain severity and effect on activities of daily living (ADLs), recreational, family and social life (RFS), and ability to work. Descriptive statistics were compiled and relationships between pain and details of amputation were examined., Results: A total of 107 patients (88 males, 19 females) participated; mean age 51.1 years. Fifty-one patients (47.7%) suffered BP, mean intensity 5.3, mean interference with ADLs, RFS, ability to work 3.5, 3.8, 3.4, respectively. Sixty (56.1%) suffer from RLP, mean intensity 5.7; mean interference with ADLs, RFS, ability to work 2.9, 2.8, 3.9, respectively. BP intensity increased with age; RLP intensity was greatest among vasculopaths., Conclusions: Irish LLAs maintain functional capacity despite suffering moderate intensity BP and RLP.

Purpose: To translate the SIGAM mobility scale into the Dutch language and to test and validate its properties in everyday practice., Method: The SIGAM mobility scale as published by Ryall et al. was translated into the Dutch language with the local used verbs for prosthetic use. The translated Dutch text was reviewed by several authors and a panel of professionals. The retranslation by a native speaker was reviewed by the original author who suggested modifications. The Dutch trial version of the mobility scale was presented to a panel of prosthetic users and therapists who advised slight modifications for better understanding of the questionnaire. IN training sessions prosthetic teams across The Netherlands were trained in the use of the translated SIGAM/WAP mobility scale., Results: During the translation there were problems with slang words and the use of specific words in the care of amputee patients. The instruction of team members and the test scoring of the questionnaire and the algorithm showed no difficulties. There was good to perfect agreement between scores in case training sessions with perfect inter observer reliability., Conclusions: With this instrument we have a specific measurement tool in the English and Dutch language to measure mobility in lower limb amputees.