title: Body image and self-esteem in lower-limb amputees.
abstract: 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 3.07±0.54 compared with 3.41±0.34 in controls (p<0.001) and a lower score in the RSE compared to controls (21.63±4.72 vs. 21.46±5.86). 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 (42.17±14.47 vs. 64.05±12.39) (p<0.001).
  
  
  CONCLUSIONS
  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 is influenced significantly by phantom pain sensation.
authors.affiliation: Department of Orthopaedic Surgery, Medical University of Graz, Graz, Austria.
authors.forename: Lukas A
authors.initials: LA
authors.lastname: Holzer
authors.affiliation: Department of Orthopaedics, Medical University of Vienna, Vienna, Austria.
authors.forename: Florian
authors.initials: F
authors.lastname: Sevelda
authors.affiliation: Department of Orthopaedics, Medical University of Vienna, Vienna, Austria.
authors.forename: Georg
authors.initials: G
authors.lastname: Fraberger
authors.affiliation: Kompetenzzentrum Automobil- und Industrieelektronik (KAI) GmbH, Villach, Austria.
authors.forename: Olivia
authors.initials: O
authors.lastname: Bluder
authors.affiliation: Orthopädisches Rehabilitationszentrum SKA Zicksee, St. Andrä am Zicksee, Austria.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Kickinger
authors.affiliation: Department of Orthopaedics, Medical University of Vienna, Vienna, Austria.
authors.forename: Gerold
authors.initials: G
authors.lastname: Holzer
mesh_terms: D000328:Adult; D000368:Aged; D000674:Amputees / Q000523:psychology* / Q000534:rehabilitation; D005260:Female; D006801:Humans; D035002:Lower Extremity; D008297:Male; D008875:Middle Aged; D010591:Phantom Limb / Q000523:psychology / Q000534:rehabilitation; D011788:Quality of Life; D012649:Self Concept; D011795:Surveys and Questionnaires