The effects of body image perception and compliance with the prosthesis on cognitive performance in transfemoral amputees

The purpose of this study was to assess the effect of body image perception and compliance with the prosthesis on cognitive performance in transfemoral amputees, and to determine the factors that can lead to possible differences. Our research has been conducted the dates between December 2016- March 2017, at Bezmialem Vakıf University. Fourty transfemoral amputee, 30 males and 10 females, who had a traumatic amputation, with the average age 37,03±9,94 years were included in this study. Participants sociodemographic, amputation-specific and prosthetics usage related informations was recorded with the General Amputee Evaluation Survey which is prepared based on literature. Participants body image perception and compliance with the prosthesis paramaters were evaluated with ABIS (Amputee Body Image Scale) and TAPES (Trinity Amputation and Prosthesis Experience Scales). The assessment of the quality of life was done by NHP (Nottingham Health Profile). MoCA (The Montreal Cognitive Assessment) has been used to determine the cognitive ability of the participants. Neuropsycological subtests has been administered by dual task method during ambulation. For statistical analysis, a Windows-based SPSS 21 analysis program was used, significance level was accepted as p<0.05). The time passed after the amputation of the participants has been determined as 12,68±9,41 years. Individuals who are included in this study has an average 10,6±8,38 years of prosthetics usage. 45% of the participants regularly participate in sportive or physical activites, 55% of them do not participate any physical activity. Depending on the type of prosthesis, %50 of the participants are using microprocessor controlled and %50 are using hydraulic prosthetic knee. There was a statistically significant correlation between the ABIS, TAPES I. part subparamaters and cognitive performance (p<0,05). The relationship between the ABIS and TAPES I. part subparameters was statistically significant (p<0,05). Satisfaction with the body image and positive compliance to prosthesis was related improved quality of life. When the participants are divided into two groups based on their prosthetic type, it showed that ABIS, TAPES I. part subparameters and NSP, cognitive performance value difference have statistically significant (p<0,05). When the same data evaluated based on participants physical activity habits, regarding to cognitive peformance; any statistically significant difference was not found (p>0,05). Our study results shows that body image perception and compliance with the prosthesis may have effect on cognitive performance. By regulating body image perception and adding psychosocial adjustment to amputee rehabilitation programs, we believe that the amputee can improve its performance in cognitive functions such as attention, memory, and orientation, which are necessary for adaptation of the acquired injury, successful use of the prosthesis and independence on activities of daily living.