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Artigos Originais • Fisioter. mov. 27 (1) • jan-mar 2014 • https://doi.org/10.1590/0103-5150.027.001.AO05 copy

Proposed use of the international classification of functioning, disability and health to evaluate quality of life after an amputation

Proposta de utilização da classificação internacional de funcionalidade, incapacidade e saúde na avaliação da qualidade de vida de pessoas com amputação

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective

To quantify the quality of life of people with a lower limb amputation, and to propose a relationship between the quality of life and the International Classification of Functioning, Disability and Health (ICF).

Materials and methods

After a retrospective study of medical records, 15 amputees met the inclusion criteria. The characteristics of the amputation and quality of life were evaluated, and both were correlated with the ICF. The 36-Item Short-Form Survey (SF-36) was used to assess quality of life.

Results

It was possible to establish ICF codes for levels of amputation and the quality of life. A high and significant correlation was found between quantitative descriptors of the ICF and SF-36 scores (r = -0.9376, p < 0.0001).

Conclusion

People with a lower limb amputation showed a reduced quality of life, which was reflected in scores from a generic questionnaire and their correlation with the ICF.

Amputation; Evaluation; Quality of life; International Classification of functioning, disability and health

Amputation level	N (%)	ICF category	ICF category description
Transfemoral	6 (40.0)	s7500.327	Structure of thigh, severe impairment, partial absence, distal
Transtibial	8 (53.3)	s7501.327	Structure of leg, severe impairment, partial absence, distal
Mid-foot	1 (6.7)	s7502.327	Structure of ankle and foot, severe impairment, partial absence, distal

SF-36 domains	ICF category	ICF category description
Physical functioning	b760	Control of voluntary movement functions: Functions associated with control over and coordination of voluntary movements.
	d2	General tasks and demand: General aspects of carrying out single or multiple tasks, organizing routines, and handling stress.
	d4	Mobility: Moving by changing body position or location or by transferring from one place to another, by carrying, moving, or manipulating objects, by walking, running, or climbing, and by using various forms of transportation.

Role-physical	b1644	Insight: Mental functions of awareness and understanding of oneself and one’s behavior.

Bodily pain	b280	Sensation of pain: Sensation of unpleasant feeling indicating potential or actual damage to some body structure.

General health	b	Body functions: Physiological functions of the body systems.
	d	Activity: The execution of a task or action by an individual. Participation: Involvement in a life situation.

Vitality	b1300	Energy level: Mental function that produce vigor and stamina.
Vitality	b4550	General physical endurance: Functions related to the general level of tolerance of physical exercise or stamina.

Social functioning	b122	Global psychosocial functions: General mental functions, as they develop over the life span, required to understand and constructively integrate the mental functions that lead to the formation of the interpersonal skills needed to establish reciprocal social interactions, in terms of both meaning and purpose.
Social functioning	d7	Interpersonal interactions and relationships: Carrying out the actions and tasks required for basic and complex interactions with people (strangers, friends, relatives, family members, and lovers) in a contextually and socially appropriate manner.

Role-emotional	b152	Emotional functions: Specific mental functions related to the feeling and affective components of the processes of the mind.

Mental health	b199	Mental function, unspecified.

ICF Qualifier		ICF			SF-36
ICF Qualifier		Quantitative magnitude of the level of health	Qualitative magnitude of the level of health		Score	Qualitative quality of life score
.0		0-4%	No problem		96-100	Highest
.1		5-24%	Mild problem		76-95	Good
.2		25-49%	Moderate problem		51-75	Regular
.3		50-95%	Severe problem		5-50	Poor
.4		96-100%	Complete problem		0-4	Lowest

SF-36 Domains	SF-36 Score	ICF Qualifier	Qualitative descriptor	R	p-value
Physical functioning	50.0	.3	Poor	−0.9442	<0.0001
Role-physical	50.0	.3	Poor	−0.9990	<0.0001
Bodily pain	80.0	.2	Regular	−0.6861	0.047
General health	72.0	.2	Regular	−0.9905	<0.0001
Vitality	50.0	.3	Poor	−0.8444	<0.0001
Social functioning	87.5	.1	Good	−0.9913	<0.0001
Role-emotional	33.3	.3	Poor	−1.0000	<0.0001
Mental health	56.0	.2	Regular	−0.8581	<0.0001

Amputation level	N (%)	SF-36 (median)	Qualitative descriptor
s7500.327	6 (40.0)	49	Poor
s7501.327	8 (53.3)	70	Regular
s7502.327	1 (6.7)	35	Poor

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