ARTICLE INFO

Article Type

Original Research

Authors

Mohamadtaghi   B. (*)
Shamsipour Dehkordi   P. (1)
Hejazi Dinan   P. (1)






(*) Physical Education Department, Sport Sciences Faculty, Alzahra University, Tehran, Iran
(1) Physical Education Department, Sport Sciences Faculty, Alzahra University, Tehran, Iran

Correspondence

Address: Sport Sciences Faculty, Alzahra University, Vanak Village, Tehran, Iran
Phone: +982332573821
Fax: +982188041468
batol.mohamadtaghi@yahoo.com

Article History

Received:  February  4, 2016
Accepted:  June 6, 2016
ePublished:  June 18, 2016

BRIEF TEXT


In 2001, Weaver defined quality of life as "an individual`s impression of his/her health status and the amount of satisfaction of this condition", which was accepted by a group of experts [1].

... [2-3]. Self- efficacy of pain is the degree of one's assurance of his/her ability to maintain the function despite pain [4]. ... [5-19].The researchers` findings indicate that the degree of pain can affect the quality of life. Haqhiqhat et al. stated in their study that a significant negative relationship is observed between the self-efficacy related to pain and perceived pain intensity in patients with multiple sclerosis [20]… [21-22].

The aim of this study was to investigate the effectiveness of physical activities on the quality of life and self-efficacy of pain in veterans and non-veterans with lower limb amputations.

This is a sectional (descriptive-analytic) study.

This study was conducted in 2015 among all the people with lower limb amputations who referred to Tehran`s Red Crescent.

110 lower limb amputated people (25 veterans and 85 non- veterans) were selected using purpose-based sampling. The criteria for entering the study included being less than 60 years old, merely suffering from lower limb amputation, suffering from lower limb amputation for at least one year, and the use of prosthesis. Lower limb amputees using antiepileptic and psychotropic drugs, amputees suffering from high-risk and chronic diseases such as cancer, multiple sclerosis, respiratory diseases such as asthma, renal failure, heart failure and neurological disorders such as cerebral palsy and Parkinson's disease were excluded from the study.

Data collection tools were questionnaires of demographic features, level of physical activity, quality of life with 12 questions and self-efficacy of pain. The Activity of Daily Life (ADL) Questionnaire: This questionnaire explains activities which are necessary for self-care including eating, dressing, using the bathroom, bathing, moving, and urinating [23]. Instrumental Activities of Daily Living (IADL) Questionnaire: This questionnaire is used to identify and evaluate complex daily activities and the degree of an individual`s dependence to the activities he/she does during the day. Guidelines for complex activities of daily life include using the cellphone, shopping, making food, working at home, going outdoors, taking drug, and handling finances. In each of these options if the person is capable of performing the specified actions, he is considered independent, and if he cannot do any of those actions he is dependent [24, 25]. The validity of ADL and IADL questionnaires has been approved by Habibi et al. [26]. 12-item Short Form Questionnaire of Life Quality (SF-12): 12-item questionnaire of Life quality is the short form of 36-item questionnaire of quality of life which is widely used in various studies. This questionnaire contains 12 questions in eight aspects [27], which has been divided into physical and mental subscales; physical subscale includes components of physical functioning, limitation of role due to physical problems, general health perception and physical pain, and mental subscale involves elements of role limitation due to psychological problems, energy and liveliness, mental status, and social functioning [28]. The validity and reliability of this questionnaire have been assessed by Montazeri et al. and been reported as accepted in Iran [29]. Pain Self-Efficacy Questionnaire (PSEQ): Pain Self-Efficacy Questionnaire is based on the concept of self-efficacy argued by Bandura. It contains 10 questions and each question examines the extent of patient`s assessment of his/her ability to carry out a series of activities despite pain, based on a 7-point Likert scale (from zero to six). The patient's score on this scale varies between zero to 60 and a higher score indicates higher self-efficacy when facing chronic pain. The Persian version of this questionnaire is proved to be reliable. Besides, the construct validity of the Persian version of PSEQ was studied in a sample of 169 patients with chronic pain and the findings reveal the desired validity and reliability of the Persian version. In addition, the results of confirmatory factor analysis indicate high construct validity for the questionnaire [30]. Central indicators of mean and standard deviation were used to describe the data. Furthermore, data normality was examined using the Kolmogorov-Smirnov test. Pearson correlation coefficient was deployed to determine the degree of correlation between variables of the research. Statistical analysis of multivariate variance (MANOVA) and Bonferroni post hoc test was employed to compare the aspects of life quality and pain self-efficacy in 6 groups of veterans with lower limb amputations (in three levels of independent, relatively dependent and dependent physical activity) and non-veterans (in three levels of independent, relatively dependent and dependent physical activity). All the subjects` data was analyzed using SPSS 19 software.

Out of 110 participants in this study, there were 25 veterans and 85 non-veterans. Each one of them was put in independent, relatively dependent and dependent groups in terms of the level of physical activity. 47 of them were female and 63 were male. The number of non-veterans with independent level of physical activity was more than others. Besides, the majority of subjects ranged from 30 to 39 years old and had university degrees (Table 1). The mean of instrumental activities of daily living (IADL) and non-instrumental activities of daily living (ADL) in non-veterans suffering from lower limb amputations with independent level of physical activity was higher than veterans with lower limb amputations (Table 2). There was a significant difference between all the components of life quality and pain self-efficacy in groups of veterans and non-veterans suffering from lower limb amputations with independent, relatively dependent and completely dependent levels of physical activity (p=0.001). The mean scores of lower limb amputated veterans with independent level of physical activity were higher than amputated non-veterans. The mean score of all the variables of physical function, mental function, quality of life and pain self-efficacy in lower limb amputated veterans with independent level of physical activity was significantly higher in comparison with groups of veterans and non-veterans with dependent and relatively dependent levels of physical activity (p<0.05). In general, the mean scores of these variables in lower limb amputated veterans with independent and relatively dependent levels of physical activity were higher than lower limb amputees with dependent level of physical activity (Table 3). There was a significant positive correlation between pain self-efficacy and physical function, mental function, quality of life, instrumental and non-instrumental daily activities; this means that the greater the scores of physical function, mental function, quality of life, instrumental and non-instrumental daily activities are in amputees, the more pain self-efficacy will be. A positive and significant correlation was also observed between the scores of instrumental and non-instrumental daily activities with the variables of physical function, mental function, quality of life, and pain self-efficacy; as much as the score of the level of instrumental and non-instrumental daily activities increased in amputees, the variables of physical function, mental function, quality of life, and pain self-efficacy rose, too (p=0.001; table 4).

... [31-35]. The results of this study are consistent with the findings by Deans et al. [16] and Pel et al. [36] who pointed out that in patients with Lower Limb Amputation (LLA), health-related quality of life has declined mainly due to motor problems; and with the results by Knittle et al. [21] who investigated the effect of physical activity and attaining the goals of such activity in relation to pain self-efficacy and quality of life in patients with rheumatoid arthritis, and stated that attaining the goal has a direct effect on the quality of life's achievements. ... [37-39]. The greater the scores of the level of instrumental and non-instrumental daily activities in amputees are, the more the variables of physical function, mental function, quality of life and pain self-efficacy are. This section of the findings is compatible with the results of the studies by Weiss et al. [40], Buckelew et al. [22], Fusetti et al. [41], Da Silva et al. [18], Muhammad and Shebl [19], and Knežević et al. [31]. ... [42-49].

Amputees are recommended to use an exercise program for preventing and alleviating the problems, and improving the quality of life and pain self-efficacy. The researchers are advised to carry out their further studies with broader domain of the people`s society who participate in social activities and group sports as well as individual sports activities.

The limited number of the subjects for the study is one of its drawbacks. Besides, the findings of this study can only be generalized to lower limb amputees; not to other people with physical diseases such as osteoarthritis, Parkinson's, etc. In addition, this study has been conducted on amputees aged from 30 to 59 and its findings cannot be generalized to elderly amputees older than 60 years old.

Lower limb amputees with independent level of physical activity have better physical function, mental function, quality of life, and higher pain self-efficacy compared to amputees with dependent and relatively dependent physical activity.

Many thanks are addressed to all the subjects of the study and those who have enormously helped us through this research.

Non-declared

This study is approved by the ethics committee of Tehran's Red Crescent organization.

This study is adapted from a research and is not financially supported by any institution or organization.

TABLES and CHARTS

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