Evaluation of activity limitation and social participation, and the effects of reconstructive surgery in people with disability due to leprosy: a prospective cohort study.
OBJECTIVE
To assess how activity limitation and social participation of individuals with leprosy-related disability change over time, and to quantify the effect of reconstructive surgery.


METHODS
Individuals with disability due to leprosy who accepted invitations for assessment at a leprosy clinic between March and July 2007 were interviewed using the SALSA Scale (measuring activity limitation) and the Participation Scale (assessing social participation). All participants were offered reconstructive surgery. Follow-up interviews were done 1 year after the first interview or 1 year after surgery. The main outcomes were changes in SALSA score and Participation score. We used analysis of variance to identify the effects of independent factors on mean SALSA and Participation scores.


RESULTS
We interviewed 222 participants, 15 of whom took up the offer of surgery and 207 who did not. Comparison of SALSA Scale scores at baseline and 1 year revealed that activity limitation did not significantly change over time in individuals who declined surgery; however, participants who had surgery showed a significant improvement at 1 year (p < 0.001). Social participation improved over time in both groups, but the difference was significant only in the non-surgery group (p < 0.001).


CONCLUSIONS
The findings suggest that reconstructive surgery has beneficial effects on functioning. Evaluation of the need for, and effect of, surgery in larger studies is recommended.
van Veen
Natasja H J
NH
Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Netherlands. n.vanveen@erasmusmc.nl
Hemo
Dinabandhu A
DA
Bowers
Robert L
RL
Pahan
David
D
Negrini
Jean-François
JF
Velema
Johan P
JP
Richardus
Jan Hendrik
JH
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000523:psychology / Q000534:rehabilitation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007918:Leprosy / Q000503:physiopathology* / Q000523:psychology / Q000534:rehabilitation* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D019651:Plastic Surgery Procedures; D020127:Recovery of Function; D018434:Sickness Impact Profile; D058992:Social Participation / Q000523:psychology*; D012959:Socioeconomic Factors; D055815:Young Adult