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Return to Work After Amputation

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Amputation, Prosthesis Use, and Phantom Limb Pain

Abstract

The main objective in the rehabilitation of people following amputation is to restore or improve their functioning, which includes their return to work. People after lower or upper limb amputation have problems returning to work and working. Owing to the different functions of our lower and upper limbs, problems at work differ between both groups.

Most authors find the return to work rate to be about 66% (from 43.5 to 100% for participants after lower limb amputation and 53–100% for people after upper limb amputation). Twenty-two (22) to 67% of people after lower limb amputation retain the same occupation following amputation. Twenty (20) to 100% after upper limb amputation have to change it. Post-amputation jobs are generally more complex with a requirement for a higher level of general educational development and are physically less demanding. The return to work depends on general factors, such as age, gender and educational level; factors related to impairments and disabilities because of amputation (amputation level, multiple amputations, co-morbidity, reason for amputation, persistent stump problems, the time from the injury to obtaining a permanent prosthesis, wearing comfort of the prosthesis, walking distance and restrictions in mobility); rehabilitation; factors related to prosthesis; and factors related to work and policies (salary, higher job involvement, good support from the implementing body and the employer and social support network).

Vocational rehabilitation and counselling should become a part of rehabilitation programs for all people, who are of working age, following amputation. Better co-operation between professionals, such as rehabilitation team members, implementing bodies, company doctors and employers is necessary.

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References

  • Atesalp AS, Erler K, Gür E, Köseğlu E, Kirdrmir V, Demiralp B (1999) Bilateral lower limb amputations as a result of landmine injuries. Prosthet Orthot Int 23:50–54

    PubMed  CAS  Google Scholar 

  • Boynton BL (1955) The rehabilitation and the re-employment potential of the amputee. Am J Surg 89:924–931

    Article  PubMed  CAS  Google Scholar 

  • Bruins M, Geertzen JH, Groothoff JW, Schoppen T (2003) Vocational reintegration after a lower limb amputation, a qualitative study. Prosthet Orthot Int 27:4–10

    PubMed  CAS  Google Scholar 

  • Burger H, Marinček (2007) Return to work after lower limb amputation. Disabil Rehabil 29:1323–1329

    Article  PubMed  Google Scholar 

  • Burger H, Maver T, Marinček (2007) Partial hand amputation and work. Disabil Rehabil 29:1317–1321

    Article  PubMed  Google Scholar 

  • Chow SP, Ng C (1993) Hand function after digital amputation. J Hand Surg Br 18B:125–128

    Google Scholar 

  • Curley MD, Walsh JM, Triplett RG (1982) Some adjustment indices of oral-maxillofacial war casualties, limb amputees, and noninjured veterans. Mil Med 147:572–574

    PubMed  CAS  Google Scholar 

  • Dasgupta AK, McCluskie PJA, Patel VS, Robins L (1997) The performance of the ICEROSS prostheses amongst transtibial amputees with a special reference to the workplace – a preliminary study. Occup Med 47:228–238

    Article  CAS  Google Scholar 

  • Davidson J (2002) A survey of the satisfaction of upper limb amputees with their prostheses, their lifestyle, and their abilities. J Hand Ther 15:62–70

    Article  PubMed  Google Scholar 

  • Dougherty CP (1999) Long-term follow-up study of bilateral above-the-knee amputees from the Vietnam War. J Bone Joint Surg Am 81-A:1384–1390

    Google Scholar 

  • Dumontier C (2003) Distal replantation, nail bed, nail problems in musicians. Hand Clin 19:259–272

    Article  PubMed  Google Scholar 

  • Ebrahimzadeh MH, Rajabi MT (2007) Long-term outcomes of patients undergoing war-related amputations of the foot and ankle. J Foot Ankle Surg 46:429–433

    Article  PubMed  Google Scholar 

  • Fernandez A, Revilla C, Su IT, Garcia M (1993) Social reintegration of juvenile amputees, comparison with a general population. Prosthet Orthot Int 27:11–16

    Google Scholar 

  • Ferrapie AL, Brunel P, Besse W, Altermatt E, Bontoux L, Richard I (2003) Lower limb proximal amputation for a tumor, a retrospective study of 12 patients. Prosthet Orthot Int 27:179–185

    Article  PubMed  CAS  Google Scholar 

  • Fisher K, Hanspal RS, Marks L (2003) Return to work after lower limb amputation. Int J Rehabil Res 26:51–56

    Article  PubMed  CAS  Google Scholar 

  • Gaine WJ, Smart C, Bransby-Zachary M (1997) Upper limb traumatic amputees. J Hand Surg Br 22B:73–76

    Google Scholar 

  • Girdhar A, Mital A, Kephart A, Young A (2001) Design guidelines for accommodating amputees in the workplace. J Occup Rehabil 11:99–118

    Article  PubMed  CAS  Google Scholar 

  • Grossman A, Goldstein L, Heim M, Barenboim E, Dudkiewicz I (2005) Trans-femoral amputee pilots, criteria for return to the fighter cockpit. Aviat Space Environ Med 76:403–405

    PubMed  Google Scholar 

  • Hacking HGA, van der Berg JP, Dahmen KT, Post MWM (1997) Long-term outcomes of upper limb prosthetic use in the Netherlands. Eur J Phys Med Rehabil 7:179–181

    Google Scholar 

  • Hattori Y, Doi K, Ikeda K, Estrella EP (2006) A retrospective study of functional outcomes after successful replantations versus amputation closure for single fingertip amputations. J Hand Surg Am 31A:811–818

    Article  Google Scholar 

  • Hebert JS, Ashworth NL (2006) Predictors of return to work following traumatic work-related lower extremity amputation. Disabil Rehabil 30:613–618

    Article  Google Scholar 

  • Hopper RA, Griffths S, Murray J, Manktelow RT (2000) Factors influencing use of digital prostheses in workers’ compensation recipients. J Hand Surg Am 25A:80–85

    Article  Google Scholar 

  • Ide M, Obayashi T, Toyonaga T (2002) Association of pain with employment status and satisfaction among amputees in Japan. Arch Phys Med Rehabil 83:1394–1398

    Article  PubMed  Google Scholar 

  • Jones LE, Davidson JH (1995) The long-term outcome of upper limb amputees treated at a rehabilitation centre in Sydney, Australia. Disabil Rehabil 17:437–442

    Article  PubMed  CAS  Google Scholar 

  • Jones L, Hall LM, Schuld W (1993) Ability or disability? A study of the functional outcome of 65 consecutive lower limb amputees treated at the Royal South Sydney Hospital in 1988–1989. Disabil Rehabil 15:184–188

    Article  PubMed  CAS  Google Scholar 

  • Kegel B, Carpenter ML, Burgess EM (1978) Functional capabilities of lower extremity amputees. Arch Phys Med Rehabil 59:109–120

    PubMed  CAS  Google Scholar 

  • Kejlaa GH (1992) The social and economic outcome after upper limb amputation. Prosthet Orthot Int 16:25–31

    PubMed  CAS  Google Scholar 

  • Kishbaugh D, Dillingham TR, Howard RS, Sinnott MW, Belandres PV (1995) Amputee solders and their return to active duty. Mil Med 160:82–84

    PubMed  CAS  Google Scholar 

  • Lifchez SD, Marchant-Hanson J, Matloub HS, Sanger JR, Dzwierzynski WW, Nguyen HH (2005) Functional improvement with digital prosthesis use after multiple digit amputations. J Hand Surg Am 30A:790–794

    Article  Google Scholar 

  • Livingston DH, Keenan D, Kim D, Elcavage J, Malagnoni MA (1994) Extent of disability following traumatic extremity amputation. J Trauma 37:495–499

    Article  PubMed  CAS  Google Scholar 

  • MacKenzie EJ, Bosse MJ, Kellam JF, Pollak AN, Webb LX, Swiontkowski MF, Smith DG et al (2006) Early predictors of long-term work disability after major limb trauma. J Trauma 61:688–694

    Article  PubMed  Google Scholar 

  • Mezghani-Masmoudi M, Guermazi M, Feki H, Ennaouai A, Dammak J, Elluch MH (2004) Facteurs lies à l’avenir fonctionnel et professionnel des amputés des members inférieurs appareillés. Ann Readapt Med Phys 47:114–118

    PubMed  CAS  Google Scholar 

  • Millstein S, Bain D, Hunter GA (1985) A review of employment patterns of industrial amputees – factors influencing rehabilitation. Prosthet Orthot Int 9(2):69–78

    PubMed  CAS  Google Scholar 

  • Nagarajan R, Neglia JP, Clohisy DR, Yasui Y, Greenberg M, Hudson M et al (2003) Education, employment, insurance, and marital status among 694 survivors of pediatric lower extremity bone tumors. Cancer 97:2554–2564

    Article  PubMed  Google Scholar 

  • Narang IC, Mathur BP, Singh P, Jape VS (1984) Functional capabilities of lower limb amputees. Prosthet Orthot Int 8:43–51

    PubMed  CAS  Google Scholar 

  • Nissen SJ, Newman WP (1992) Factors influencing reintegration to normal living after amputation. Arch Phys Med Rehabil 73:548–551

    PubMed  CAS  Google Scholar 

  • Pedersen P, Damholt V (1994) Rehabilitation after amputation following lower – limb fracture. J Trauma 36:195–197

    Article  PubMed  CAS  Google Scholar 

  • Pezzin LE, Dillingham TR, MacKenzie EJ (2000) Rehabilitation and the long-term outcomes of persons with trauma-related amputation. Arch Phys Med Rehabil 81:292–300

    Article  PubMed  CAS  Google Scholar 

  • Pohjolainen T, Alaranta H, Karkkainen M (1990) Prosthetic use and functional and social outcome following major lower limb amputation. Prosthet Orthot Int 14:75–79

    PubMed  CAS  Google Scholar 

  • Pylatiuk C, Schulz S, Döderlein L (2007) Results of an internet survey of myoelectric prosthetic hand users. Prosthet Orthot Int 31:362–370

    Article  PubMed  Google Scholar 

  • Reed D (2004) Understanding and meeting the needs of farmers with amputations. Orthop Nurs 23:397–405

    PubMed  Google Scholar 

  • Ross C, Mirowskay J (1995) Does employment affect health? J Health Soc Behav 36:230–243

    Article  PubMed  CAS  Google Scholar 

  • Rotter K, Sanhueza R, Robles K, Godoy M (2006) A descriptive study of traumatic lower limb amputees from the hospital del Trabajador, Clinical evolution from the accident until rehabilitation discharge. Prosthet Orthot Int 30:81–86

    Article  PubMed  Google Scholar 

  • Sagiv P, Shabat S, Mann M, Ashur H, Nyska M (2002) Rehabilitation process and functional results of patients with amputated fingers. Plast Reconstr Surg 110:497–503

    Article  PubMed  Google Scholar 

  • Schoppen T, Boonstra A, Groothoff JW, de Vries J, Goeken LNH, Eisma WH (2001a) Employment status, job characteristics, and work-related health experience of people with a lower limb amputation in the Netherlands. Arch Phys Med Rehabil 82:239–245

    Article  PubMed  CAS  Google Scholar 

  • Schoppen T, Boonstra A, Groothoff JW, van Sonderen E, Goeken LNH, Eisma WH (2001b) Factors related to successful job reintegration of people with a lower limb amputation. Arch Phys Med Rehabil 82:1425–1431

    Article  PubMed  CAS  Google Scholar 

  • Schoppen T, Boonstra A, Groothoff JW, de Vries J, Goeken LNH, Eisma WH (2002) Job satisfaction and health experience of people with a lower-limb amputation in comparison with healthy colleagues. Arch Phys Med Rehabil 83:628–634

    Article  PubMed  Google Scholar 

  • Silcox DH, Rooks MD, Vogel RR, Fleming LL (1993) Myoelectric prostheses. J Bone Joint Surg 75-A:1781–1789

    Google Scholar 

  • Smith JJ, Agel D, Swiontkowski MF, Castillo R, Mackenzie E, Kellam JM (2005) Functional outcome of bilateral limb threatening – lower extremity injuries at two years postinjury. J Orthop Trauma 19:249–253

    Article  PubMed  Google Scholar 

  • Somasundaram DJ, Renol KK (1998) The psychosocial effects of landmines in Cambodia. Med Confl Surviv 14:219–236

    Article  PubMed  CAS  Google Scholar 

  • Stürup J, Tyregod HC, Jensen JS, Retpen JB, Boberg G, Rasmussen E, Jensen S (1988) Ttraumatic amputation of the upper limb, the use of body-powered prostheses and employment consequences. Prosthet Orthot Int 12:50–52

    PubMed  Google Scholar 

  • Whyte AS, Carroll LJ (2002) A preliminary examination of the relationship between emplyment, pain and disability in an amputee population. Disabil Rehabil 24:462–470

    Article  PubMed  CAS  Google Scholar 

  • Wright TW, Hagen AD, Wood MB (1995) Prosthetic usage in major upper limb extremity amputations. J Hand Surg Am 20A:619–622

    Article  Google Scholar 

  • Yonemoto T, Ishii T, Takeuchi Y, Kimura K, Hagiwara Y, Tatezaki S (2007) Education and employment in long-term survivors of high-grade osteosarcoma, a Japanese single-center experience. Oncology 72:274–278

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Institute of Rehabilitation, Ljubljana, Slovenia

    Helena Burger

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  1. Helena Burger
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Correspondence to Helena Burger .

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  1. Dept. Psychology, University of Manchester, Oxford Road, Manchester, M13 9PL, United Kingdom

    Craig Murray

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Burger, H. (2009). Return to Work After Amputation. In: Murray, C. (eds) Amputation, Prosthesis Use, and Phantom Limb Pain. Springer, New York, NY. https://doi.org/10.1007/978-0-387-87462-3_7

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  • DOI: https://doi.org/10.1007/978-0-387-87462-3_7

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