title: A study of the physical rehabilitation and psychological state of patients who sustained limb loss as a result of terrorist activity in Northern Ireland 1969-2003.
abstract: OBJECTIVE
  To benchmark the psychological state and physical rehabilitation of patients who have sustained limb loss as a result of terrorist activity in Northern Ireland and to determine their satisfaction with the period of primary prosthetic rehabilitation and the artificial limb.
  
  
  METHODS
  All patients who sustained limb loss as a result of the Troubles and were referred to our rehabilitation centre were sent a questionnaire. The main outcome measures were the SIGAM mobility grades, the General Health Questionnaire (GHQ12) and three screening questions for Post Traumatic Stress Disorder (PTSD).
  
  
  RESULTS
  Out of a 66% response rate, 52 (69%) patients felt that the period of primary prosthetic rehabilitation was adequate; 32 (54%) lower limb amputees graded themselves SIGAM C or D; 45 (60%) patients stated that they were still having significant stump pain. Significant stump pain was associated with poorer mobility. Nine (56%) upper limb amputees used their prosthetic limb in a functional way; 33 (44%) patients showed "psychiatric caseness" on the GHQ 12 and 50 (67%) had symptoms of PTSD.
  
  
  CONCLUSIONS
  Most patients felt that the period of physical rehabilitation had been adequate; those who did not were more likely to be having ongoing psychological problems. A high percentage of patients continue to have psychological problems and stump pain.
authors.affiliation: Musgrave Park Hospital, Belfast, Northern Ireland, UK. lorradam@yahoo.com
authors.forename: Lorraine
authors.initials: L
authors.lastname: Graham
authors.forename: R C
authors.initials: RC
authors.lastname: Parke
authors.forename: M C
authors.initials: MC
authors.lastname: Paterson
authors.forename: M
authors.initials: M
authors.lastname: Stevenson
mesh_terms: D000293:Adolescent; D000328:Adult; D000673:Amputation, Traumatic / Q000523:psychology / Q000534:rehabilitation*; D000674:Amputees / Q000523:psychology*; D001186:Artificial Limbs; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009660:Northern Ireland; D017063:Outcome Assessment, Health Care; D010591:Phantom Limb; D013313:Stress Disorders, Post-Traumatic; D023481:Terrorism