8.13 Body weight and fitness
The research literature on body weight gain has focused primarily on male participants with lower limb amputations. The research shows that males with a lower limb amputation can experience a 8–9% weight increase, and in some studies up to a 14 kg increase, after the amputation [92, 93]. One study identified that, for some participants, body mass index (BMI) at six weeks post amputation was lower than their pre-amputation BMI, but by 12 months after amputation, their BMI was higher than before the amputation and their overall mobility decreased [94]. The research also shows that the weight gain for people with lower limb amputations can be slow, but for 40–42% of people with a lower limb amputation, their weight starts to increase at 12 weeks after amputation and continues for years [95, 96]. This is consistent with the preliminary research for this guidance. A comprehensive file review of a sample of 20 participants at icare revealed that 40% of participants had a weight increase (all of whom had lower limb amputations) and only 10% had a weight decrease. The weight increase contributed to difficulties with fitting the prosthesis, delays in provision of the definitive prosthesis, or complications which led to requiring a new socket.
Maintaining a healthy body weight and fitness is important for any person, to enhance life in general, long-term functioning and outcomes. Maintaining a healthy body weight and fitness are critical for people with an amputation, particularly for those with lower limb amputation. A combination of exercises for people with lower limb amputation have been shown to have positive effects on cardiovascular fitness, muscular fitness and functioning (distance walked, functional mobility and capacity) [90]. Yet many people with limb amputation (whether related to trauma or to vascular conditions) are vulnerable to not exercising adequately, and can experience weight gain and reduced cardiovascular fitness [91].
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Some contextual factors that may contribute to weight gain and lower fitness are:
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the time spent in hospital
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being sedentary and experiencing long periods when mobility is restricted due to medication and pain management issues (refer to Section 9.4 Pain)
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stump (residual limb) changes (see Section 8.14)
psychosocial concerns and adjustment to the amputation (including body image)
delays in treatment, prosthetic trial and supply particular stages in the support pathway such as when therapy stops.
© icareTM | Insurance and Care NSW 2021
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icare Guidance for people with a limb amputation 2021
