Pain and health-related quality of life for children with lower limb absence - an exploratory study
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Accepted version
Author(s)
Type
Journal Article
Abstract
Objective: To investigate health-related quality of life, pain, socket comfort, and residual limb conditions in children with lower-limb absence.
Design: This is a cross-sectional study with patient-reported outcomes measures collected from children with congenital and acquired lower-limb absence. Outcomes included health-related quality of life, body pain mapping, socket comfort score, clinical evaluation of the residual limb. Effects of age, prosthetic technology, school attendance and pain on health-related quality of life and socket comfort were investigated.
Setting: Data from 31 children were collected in prosthetic centres in the UK (N=15) and Cambo-dia (N=16).
Results: This cohort had a clinically important reduction in health-related quality of life com-pared to normative data (Δ=13.21). Psychosocial health declined with age (ρ=-0.394, p=0.014). Low intensity pain in the residual limb, back and intact joints was frequent and negatively corre-lated with health-related quality of life (ρ=-0.327, p=0.036). Socket comfort was positively corre-lated with physical wellbeing (ρ=0.398, p=0.013). Unplanned emergency amputations resulted in worse residual limb outcomes than planned surgeries (p=0.02).
Conclusion: This cohort experience significant, under-addressed challenges in physical and men-tal wellbeing. Declining mental wellbeing underscores the urgent need for age-appropriate psy-chological support, that addresses the evolving social and emotional demands of growing up with a disability. The prevalence of widespread pain highlights the need for targeted gait training and improved prosthetic fit and design. Poorer residual limb health outcomes following emer-gency amputations reinforce the importance of paediatric-specific surgical and post-operative protocols. Holistic, child-centred care integrating physical, psychological, and social support is essential.
Design: This is a cross-sectional study with patient-reported outcomes measures collected from children with congenital and acquired lower-limb absence. Outcomes included health-related quality of life, body pain mapping, socket comfort score, clinical evaluation of the residual limb. Effects of age, prosthetic technology, school attendance and pain on health-related quality of life and socket comfort were investigated.
Setting: Data from 31 children were collected in prosthetic centres in the UK (N=15) and Cambo-dia (N=16).
Results: This cohort had a clinically important reduction in health-related quality of life com-pared to normative data (Δ=13.21). Psychosocial health declined with age (ρ=-0.394, p=0.014). Low intensity pain in the residual limb, back and intact joints was frequent and negatively corre-lated with health-related quality of life (ρ=-0.327, p=0.036). Socket comfort was positively corre-lated with physical wellbeing (ρ=0.398, p=0.013). Unplanned emergency amputations resulted in worse residual limb outcomes than planned surgeries (p=0.02).
Conclusion: This cohort experience significant, under-addressed challenges in physical and men-tal wellbeing. Declining mental wellbeing underscores the urgent need for age-appropriate psy-chological support, that addresses the evolving social and emotional demands of growing up with a disability. The prevalence of widespread pain highlights the need for targeted gait training and improved prosthetic fit and design. Poorer residual limb health outcomes following emer-gency amputations reinforce the importance of paediatric-specific surgical and post-operative protocols. Holistic, child-centred care integrating physical, psychological, and social support is essential.
Date Acceptance
2026-06-09
Citation
Clinical Rehabilitation
ISSN
0269-2155
Publisher
SAGE Publications
Journal / Book Title
Clinical Rehabilitation
Copyright Statement
Copyright This paper is embargoed until publication. Once published the author’s accepted manuscript will be made available under a CC-BY License in accordance with Imperial’s Research Publications Open Access policy (www.imperial.ac.uk/oa-policy).
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Publication Status
Accepted