title: Utilization and Perception of Peer-Support After Lower Limb Loss in the United States: Potential Benefits on Mobility Outcomes
Creators: name: Maluotoga, Moriah
Publisher: name: University of Nevada, Las Vegas
Year: 2023

description: Introduction: Limb loss is a life-changing event that significantly impacts patients’ functioning as well as psychosocial well-being. Psychosocial support in the form of amputee peer-support is widely recognized as beneficial to individuals after lower limb loss (LLL). However, there is currently a lack of research on the utilization of peer-support after LLL and its perceived benefits to function. The purpose of this cross-sectional study was to examine and quantify participants’ experiences with peer-support after LLL, and how peer-support experience is associated with mobility outcomes. We hypothesized that participants with LLL would express generally positive experiences with peer-support and that it would have a positive impact on their outlook on life and functioning during activities of daily living (ADL). We also hypothesized that individuals who have received peer-support would exhibit higher levels of mobility compared to those without such experiences. Methods: A 32-item survey was developed to examine respondents’ amputation history, experiences in peer-support activities, and their mobility (measured using Prosthetic Limb Users Survey of Mobility, PLUS-M). The items were developed and validated by 2 experienced amputee peer-support group organizers, prosthetic clinicians (physical therapists and prosthetists), and 5 persons with LLL. The online survey was distributed nationally to 169 peer-support groups and limb loss care facilities in 44 U.S. states, as well as social media-based support groups from March 2021 through February 2022. Individuals both with and without peer-support experience were included. Descriptive statistics were used to analyze the patterns of peer-support utilization and participants’ perception. Independent t-tests were conducted to examine the effects of peer-support experience on mobility outcomes. Results: 82 completed responses were extracted for data analysis (53% female, 54% over 55 years of age, 65% with transtibial amputation). Sixty-eight % of the respondents received peer-support after amputation, among them 75% reported that peer-support had a positive impact on their outlook on life, and 78% reported that information gained during their peer-support experience was helpful to their ADL. Companionship afforded by peer-support was one of the most enjoyable experiences. Respondents who received peer-support exhibited a trend of higher mobility than those who did not (55 vs. 36 percentile on PLUS-M; p=0.055), despite their comparable ages (56.7 vs. 54.4 years; p=0.211). Conclusion: Individuals with LLL reported generally positive experiences regarding their engagement in peer-support activities. Peer-support groups are viewed as a helpful source for both information and emotional support, benefiting functional and psychological recovery after amputation. Furthermore, individuals who have received peer-support exhibited greater mobility. Future research should explore how peer-support may be incorporated to improve the effectiveness and patient experience of rehabilitation after LLL.