A perspective on prosthetic technology and mental health of lower limb amputees

Amputation can be a widely distressful event for an individual. Depression and anxiety are common problems among patients who have suffered from amputation [1].

A high-tech prosthesis can now offer the possibility of regaining mobility and some day-to-day independence. But, as Williamson et al mentioned almost 30 years ago, in 1994, while such technology is welcome and exciting because of its rehabilitative potential, it is important that attention is also focused on psychosocial issues that may affect physical rehabilitation [2].  After amputation, individuals have severe mental problems such as anger, introversion, helplessness, and decreased self-esteem. The negative attitude of their families, who are expected to be supportive during this period, negatively affects the adaptation process of the individuals. A notable point is that individuals state that they could talk and feel relieved and get support if they had access to a mental health professional [3]. 

Discoveries like these leave room for the prosthetic industry to step in. A standardized mobility report can become a tool for helping clinics perform a better psychiatric diagnosis of the amputee and create conditions for efficient management of the psychological distress about amputation. Eventually, the patients’ movements might become slower, stiffer, and more hesitant, due to a range of reasons, from pain to demotivation. This loss of mobility can further worsen health problems. It can also reduce connections with friends and loved ones and engagement in activities the patient enjoys. The situation is a slippery slope to spiralize and severely affect the patients’ mood, leading to depression [4]. Mobility monitoring can tip out the clinic of the development of low mobility rates and prevent the worsening of the patient’s mental health.  

With interoperability (the ability of different computerized products or systems to readily connect and exchange information with one another) a prosthetic surveillance device that collects mobility data in a real-world environment, like a Fitbit or even a SMART socket integration, could share this data with the patient’s clinic, becoming a contact point for psychology support. 

This kind of device could become a door for standardized methods of making psychiatric assessments for lower-limb amputees and draw out symptoms using scales, along as becoming able to assess the effectiveness of clinic interventions among amputees in a day-to-day environment. 

Refs: 

[1] Sagar, R., Sahu, A., Sarkar, S., & Sagar, S. (2016). Psychological effects of amputation: A review of studies from India. Industrial Psychiatry Journal, 25(1), 4. https://doi.org/10.4103/0972-6748.196041 

[2] Desmond, D., & MacLachlan, M. (2002). Psychological issues in prosthetic and orthotic practice. Prosthetics & Orthotics International, 26(3), 182–188. https://doi.org/10.1080/03093640208726646 

[3] ŞImsek, N., ÖZtürk, G. K., & Nahya, Z. N. (2020). The Mental Health of Individuals with Post-Traumatic Lower Limb Amputation: A Qualitative Study. Journal of Patient Experience, 7(6), 1665–1670. https://doi.org/10.1177/2374373520932451 

[4] Harvard Health. (2021, May 27). Mind, mood, and mobility. https://www.health.harvard.edu/healthbeat/mind-mood-and-mobility 

[5] Williamson GM, Schultz R, Bridges MW, Behan AM (1994). Social and psychological factors in adjustment to limb amputation. J Soc Behav Per 9, 249-268