Body Image and Self-Esteem in Lower-Limb Amputees

Background: Limb amputation is often an inevitable procedure in the advanced condition of various diseases and poses a dramatic impact on a patient’s life. The aim of the present study is to analyze the impact of lower-limb amputations on aesthetic factors such as body image and self-esteem as well as quality of life (QoL). Methods: 298 patients (149 uni- or bilateral lower-limb amputees and 149 controls) were included in this cross-sectional study in three centers. Demographic data was collected and patients received a 118-item questionnaire including the Multidimensional Body-Self Relations Questionnaire (MBSRQ), the Rosenberg Self-esteem (RSE) scale and the SF-36 Health Survey (QoL). ANOVA and student’s t-test were used for statistical analysis. Results: Unilateral lower-limb amputees showed a significant lower MBSRQ score of 3.0760.54 compared with 3.4160.34 in controls (p,0.001) and a lower score in the RSE compared to controls (21.6364.72 vs. 21.4665.86). However, differences were not statistically significant (p = 0.36). Patients with phantom pain sensation had a significantly reduced RSE (p = 0.01). The SF-36 health survey was significantly lower in patients with lower-limb amputation compared to controls (42.17614.47 vs. 64.05612.39) (p,0.001). Conclusion: This study showed that lower-limb amputations significantly influence patients ’ body image and QoL. Self-esteem seems to be an independent aspect, which is not affected by lower-limb amputation. However, self-esteem i