Scientific/Clinical Article| Volume 31, ISSUE 4, P494-501, October 2018

Psychosocial reactions to upper extremity limb salvage: A cross-sectional study

Published:August 09, 2017DOI:


      Study Design

      Descriptive cross-sectional survey study.


      Limb salvage spares an extremity at risk for amputation after a major traumatic injury. Psychosocial recovery for individuals with lower extremity limb salvage has been discussed in the literature. However, to date, psychosocial reactions for individuals with upper extremity (UE) limb salvage have not been examined.

      Purpose of the Study

      To determine which factors may influence psychosocial adaptation to UE limb salvage.


      Participants (n = 30; 28 males) were adults (mean, 30.13; range, 18-61) who sustained an UE limb salvage from a traumatic event. Adaptation was measured using a modified version of the Reactions to Impairment and Disability Inventory.


      A linear mixed-effects regression found that worse psychosocial adaptation was associated with having less than a college degree, being less than 6 months post-injury, being older than 23 years, and having more pain. Dominant hand injuries were found to influence poor adaptation on the denial Reactions to Impairment and Disability Inventory subscale only.


      The results of this study indicate that there is potential for nonadaptive reactions and psychological distress with certain variables in UE limb salvage. Therapists may use these results to anticipate which clients may be at risk for poor psychosocial outcomes.


      This study indicates the need for early consideration to factors that affect psychological prognosis for the UE limb salvage population. However, future research is indicated to better understand the unique psychosocial challenges and needs of these individuals.

      Level of Evidence



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      JHT Read for Credit

      Quiz: #573

      Record your answers on the Return Answer Form found on the tear-out coupon at the back of this issue or to complete online and use a credit card, go to There is only one best answer for each question.
      • #1.
        The purpose was to identify _____________ following upper limb salvage
        • a.
          functional levels
        • b.
          best practices in hand therapy
        • c.
          the incidence of such injuries in the US and Canada vs. the EU
        • d.
          factors impacting psychosocial adaptation
      • #2.
        Adaptation was assessed using a modified
        • a.
        • b.
          Mayo Hand Function Survey
        • c.
        • d.
          Gilbert and Sullivan Upper Limb Assessment Tool
      • #3.
        The following did NOT adversely affect adaptation
        • a.
        • b.
        • c.
          having less than a college degree
        • d.
          being greater than 23 years old
      • #4.
        The following has/have been identified as one of numerous non-adaptive reactions
        • a.
          internalized delusions
        • b.
          externalized hostility
        • c.
          bipolar behavior
        • d.
          recurrent micro aggressions
      • #5.
        The findings may assist clinicians anticipate potential adaptation problems
        • a.
        • b.
      When submitting to the HTCC for re-certification, please batch your JHT RFC certificates in groups of 3 or more to get full credit.