title: Environmental barriers, activity limitations and participation restrictions experienced by people with major limb amputation.
abstract: BACKGROUND
  Limited research is available that explores major limb amputation and the World Health Organization's International Classification of Functioning, Disability and Health (ICF).
  
  
  OBJECTIVE
  To investigate the barriers, participation restriction and functioning levels experienced by people with a major limb amputation.
  
  
  METHODS
  Secondary data analysis.
  
  
  METHODS
  Relevant data for 148 people with major limb amputation were extracted from the National Physical and Sensory Disability Database in Ireland.
  
  
  RESULTS
  The most common environmental barriers encountered were climate, physical environment and income. Participation restriction was most commonly experienced in sports/physical recreation, leisure/cultural activity and employment/job-seeking. For daily activities and functioning, the most common difficulties were with standing for long periods, walking long distances and the emotional effects of disability. Differences were found between people with an upper limb or lower limb prosthesis.
  
  
  CONCLUSIONS
  This paper addresses the limited information available on environmental barriers, activity limitation and participation restriction of people with a major limb amputation. Greater understanding of the impact of amputation and prosthesis type on activity, participation and environmental barriers is important to facilitate improved management and planning at the individual, service and societal level.
  
  
  CONCLUSIONS
  Improved understanding of environmental barriers and challenges, activity limitations and participation restrictions experienced by individuals with major limb amputation is a critical step in informing evidence-based service delivery, intervention and policy in order to improve outcomes for this group.
authors.affiliation: School of Nursing, Faculty of Science and Health, Dublin City University, Dublin 9, Ireland. pamela.gallagher@dcu.ie
authors.forename: Pamela
authors.initials: P
authors.lastname: Gallagher
authors.forename: Mary-Ann
authors.initials: MA
authors.lastname: O'Donovan
authors.forename: Anne
authors.initials: A
authors.lastname: Doyle
authors.forename: Deirdre
authors.initials: D
authors.lastname: Desmond
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000671:Amputation, Surgical; D000674:Amputees; D001186:Artificial Limbs; D016208:Databases, Factual; D004185:Disability Evaluation; D005121:Extremities / Q000601:surgery; D005260:Female; D006801:Humans; D007494:Ireland; D008297:Male; D008875:Middle Aged; D012931:Social Environment; D058992:Social Participation