Physical and mental health outcomes in Syrian lower limb amputees: the impact of prosthetic rehabilitation in post-conflict settings.

introductionLower limb amputation has a significant impact on an individual’s overall quality of life, with prosthetic devices serving as essential tools for rehabilitation and mobility restoration. In Syria, where access to advanced medical care remains constrained, identifying the key factors affecting the well-being of prosthesis users is crucial for enhancing rehabilitation strategies. This study examines the sociodemographic and health-related determinants influencing the quality of life among lower-limb amputees who rely on prosthetic devices in Syria.

methodsThis research employed a cross-sectional observational study design at a highly specialized disability care facility within a tertiary hospital. Data were collected between September 2023 and August 2024. Participants were recruited using a convenience sampling method from patients receiving treatment at the same medical institution. A total of 233 individuals with lower limb amputations, all of whom had been using prosthetic limbs for at least five years, participated in the study. Data collection encompassed sociodemographic details, health status, and pain-related experiences. The Short Form Health Survey – 12 Items (SF-12) questionnaire was utilized to assess health-related quality of life (HrQoL), scores were transformed to norm-based T-scores, and PCS/MCS were dichotomized at 50 (≥ 50 = high HrQoL). In addition to overall summaries, subgroup descriptives were reported by cause of amputation (Syrian-crisis–related vs. other). Primary inferential analyses used multivariable logistic regression (limited, literature-informed covariates) to estimate adjusted associations with high PCS-12 and MCS-12; exploratory bivariate results were considered secondary. During the data-collection window, 233 eligible individuals consented and were enrolled, exceeding the calculated minimum sample size. Convenience sampling was used to include all eligible and available patients within the recruitment timeframe given clinic scheduling and resource constraints.

resultsThe study assessed HrQoL among 233 prosthesis users: 62.23% had high MCS and 66.09% had high PCS. Over half of amputations were Syrian-crisis–related (54.51%); subgroup summaries (crisis vs. other) are presented alongside overall results. In adjusted models, age, marital status, and pain-related factors (including stump-pain severity, treatment, perceived treatment effectiveness, and residual stump pain) showed independent associations with PCS and/or MCS. Limb dominance was associated with PCS, and cause of amputation was associated with MCS.

conclusionThese findings emphasize the significant impact of adjusted predictors including age, marital status, limb dominance, cause of amputation, and stump pain treatment on the quality of life of lower limb amputees. They highlight the importance of developing comprehensive rehabilitation programs that prioritize effective pain management, social support, and personalized care tailored to the unique demographic and clinical needs of each individual.