Dissociation between Psychosocial Quality of Life and Biomechanical Functionality in Lower Limb Prosthesis Users: A Cross-Sectional Study at the Central Military Hospital (2021-2024).
Keywords:
Amputation, Quality of Life, Biomechanics, Risk of Falls, Neuroplasticity, Military Medicine.Abstract
Introduction: The loss of a lower limb affects the biopsychosocial sphere. Although prosthetic fitting aims for reintegration, a gap persists between perceived quality of life and objective functional stability, influenced by neuroplasticity and cognitive adaptation.
Objective: To evaluate the relationship between health-related quality of life (HRQoL) and biomechanical functionality in patients with lower limb prostheses at the Central Military Hospital.
Materials and Methods: Observational, descriptive, and cross-sectional study of 30 patients (mean age 45.2 years; 80% male). The SF-36 instrument was used to assess HRQoL, the Timed Up and Go (TUG) instrument for mobility, the Berg Balance Scale (BBS) for balance, and the Houghton Scale for prosthesis use. Descriptive statistics and Spearman correlations (p < 0.05) were used for the analysis.
Results: A marked functional dissociation was identified. 63.3% of patients reported optimal levels of mental health; however, 70% presented a high risk of falls (TUG >13.5 s) and 63.3% an intermediate risk of instability (BBS). Although 53.3% perceived themselves as "independent," objective biomechanical deficits were detected. No significant correlation was found between psychological well-being and gait speed (r = 0.12).
Conclusions: A "resilience paradox" exists in the military population: emotional well-being and perceived independence do not coincide with biomechanical safety. Cortical reorganization and dependence on conscious motor control increase the risk of falls, making it imperative to implement advanced neuromuscular training protocols in the initial prosthetic phase.
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