{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:45:06Z","timestamp":1787010306031,"version":"build-2736575974"},"reference-count":41,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>People with physical disabilities are at risk for social isolation, which has been shown to negatively influence health and well-being.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective(s):<\/jats:title>\n                    <jats:p>The purpose of this study was to examine the association of social disconnectedness and perceived social isolation (PSI) on health-related quality of life (HrQoL) and life satisfaction in adults with dysvascular lower extremity amputation (LEA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Cross-sectional survey.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Data were collected from community-dwelling adults with dysvascular major LEA (N = 231). The main outcome measures were the Short-Form 36 and the Life Satisfaction-11. Other measures were used to quantify comorbidities\/secondary health conditions, PSI, social disconnectedness, self-efficacy, social support, and social engagement. Three hierarchical regression models were conducted to predict (1) physical HrQoL, (2) mental HrQoL, and (3) life satisfaction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Approximately one-third of the sample had high levels of social disconnectedness and PSI. The regression model predicting physical HrQoL accounted for 47% of the variance and only found that higher levels of mobility, lower perceived impact of comorbidities\/conditions, and higher levels of social engagement and self-efficacy were associated with better physical HrQoL. A model predicting mental HrQoL accounted for 36% of the variance, with older age, lower PSI, and higher levels of self-efficacy being significant predictors. Finally, the model predicting life satisfaction accounted for 56% of the variance, with older age, lower perceived impact of comorbidities\/conditions, and higher self-efficacy remaining as significant predictors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>These findings highlight that one-third of our sample were at risk for being socially isolated and that PSI was influential on mental HrQoL and life satisfaction. There is a need for approaches to address social isolation for people with dysvascular LEA living in the community to optimize their long-term health and well-being.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/pxr.0000000000000069","type":"journal-article","created":{"date-parts":[[2021,12,21]],"date-time":"2021-12-21T15:01:17Z","timestamp":1640098877000},"page":"155-163","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":16,"title":["Examination of social disconnectedness and perceived social isolation on health and life satisfaction in community-dwelling adults with dysvascular lower limb loss"],"prefix":"10.1097","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9139-9250","authenticated-orcid":false,"given":"Sander L.","family":"Hitzig","sequence":"first","affiliation":[{"name":"St John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada"},{"name":"Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada"},{"name":"Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0840-7326","authenticated-orcid":false,"given":"Steven","family":"Dilkas","sequence":"additional","affiliation":[{"name":"West Park Healthcare Centre, Toronto, Ontario, Canada"},{"name":"Division of Physical Medicine and Rehabilitation, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael W.","family":"Payne","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine & Rehabilitation, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3503-7025","authenticated-orcid":false,"given":"Crystal","family":"MacKay","sequence":"additional","affiliation":[{"name":"Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada"},{"name":"West Park Healthcare Centre, Toronto, Ontario, Canada"},{"name":"Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0520-2352","authenticated-orcid":false,"given":"Ricardo","family":"Viana","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine & Rehabilitation, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Devlin","sequence":"additional","affiliation":[{"name":"West Park Healthcare Centre, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4744-5520","authenticated-orcid":false,"given":"Stephanie R.","family":"Cimino","sequence":"additional","affiliation":[{"name":"Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9552-9139","authenticated-orcid":false,"given":"Sara J.T.","family":"Guilcher","sequence":"additional","affiliation":[{"name":"Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada"},{"name":"Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada"},{"name":"Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada"},{"name":"MAP Centre for Urban Health Solutions, St Michael\u2019s Hospital, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7061-2529","authenticated-orcid":false,"given":"Amanda L.","family":"Mayo","sequence":"additional","affiliation":[{"name":"St John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada"},{"name":"Division of Physical Medicine and Rehabilitation, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada."},{"name":"St John\u2019s Rehabilitation Hospital, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,12,14]]},"reference":[{"key":"R1-20250818","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1111\/ggi.12016","article-title":"Rehabilitation of the older vascular amputee: a review of the literature","volume":"13","author":"Fleury","year":"2013","journal-title":"Geriatr Gerontol Int"},{"key":"R2-20250818","doi-asserted-by":"crossref","first-page":"776","DOI":"10.1053\/apmr.2001.21856","article-title":"Rehabilitation of the geriatric vascular amputee patient: a population-based study","volume":"82","author":"Fletcher","year":"2001","journal-title":"Arch Phys Med Rehabil"},{"key":"R3-20250818","first-page":"552","article-title":"Evolving trends in the epidemiology, risk factors, and prevention of type 2 diabetes: a review","volume":"34","author":"Weisman","year":"2018","journal-title":"Can J Cardiol"},{"key":"R4-20250818","first-page":"1","article-title":"A depiction of rehabilitation patients 65 years and younger with dysvascular lower extremity amputation","volume":"2","author":"Mayo","year":"2019","journal-title":"Can Prosthet Orthot J"},{"key":"R5-20250818","doi-asserted-by":"crossref","first-page":"63","DOI":"10.3109\/03093648909078214","article-title":"Primary survival and prosthetic fitting of lower limb amputees","volume":"13","author":"Pohjolainen","year":"1989","journal-title":"Prosthet Orthot Int"},{"key":"R6-20250818","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1080\/03093640802492434","article-title":"Outcomes of individuals with transfemoral and contralateral transtibial amputation due to dysvascular etiologies","volume":"33","author":"Bhangu","year":"2009","journal-title":"Prosthet Orthot Int"},{"key":"R7-20250818","doi-asserted-by":"crossref","DOI":"10.1111\/dme.13680","article-title":"Diabetes-related lower-extremity complications are a leading cause of the global burden of disability","author":"Lazzarini","year":"2018","journal-title":"Diabet Med"},{"key":"R8-20250818","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1590\/1413-78522015230200990","article-title":"Anxiety, depression and quality of life in individuals with phantom limb pain","volume":"23","author":"Padovani","year":"2015","journal-title":"Acta Ortop\u00e9dica Bras"},{"key":"R9-20250818","doi-asserted-by":"crossref","first-page":"587","DOI":"10.2340\/16501977-1146","article-title":"Change in health-related quality of life in the first 18 months after lower limb amputation: a prospective, longitudinal study","volume":"45","author":"Fortington","year":"2013","journal-title":"J Rehabil Med"},{"key":"R10-20250818","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1080\/03093640802016514","article-title":"Physical activity and quality of life: a study of a lower-limb amputee population","volume":"32","author":"Deans","year":"2008","journal-title":"Prosthet Orthot Int"},{"key":"R11-20250818","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1080\/03093640802024955","article-title":"Predictors of quality of life among individuals who have a lower limb amputation","volume":"32","author":"Asano","year":"2008","journal-title":"Prosthet Orthot Int"},{"key":"R12-20250818","doi-asserted-by":"crossref","first-page":"862","DOI":"10.1080\/09638280410001708878","article-title":"A two-year longitudinal study of social support following amputation","volume":"26","author":"Williams","year":"2004","journal-title":"Disabil Rehabil"},{"key":"R13-20250818","doi-asserted-by":"crossref","first-page":"1274","DOI":"10.1016\/j.apmr.2021.02.027","article-title":"Self-management to improve function after amputation: a randomized controlled trial of the VETPALS intervention","volume":"102","author":"Turner","year":"2021","journal-title":"Arch Phys Med Rehabil"},{"key":"R14-20250818","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1177\/1524839904266792","article-title":"A review and synthesis of research evidence for self-efficacy-enhancing interventions for reducing chronic disability: implications for health education practice (part II)","volume":"6","author":"Marks","year":"2005","journal-title":"Health Promot Pract"},{"key":"R15-20250818","first-page":"453","article-title":"Self-efficacy and social support are associated with disability for ambulatory prosthesis users after lower-limb amputation","volume":"13","author":"Miller","year":"2021","journal-title":"Pharm Manag PM R"},{"key":"R16-20250818","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.puhe.2017.07.035","article-title":"An overview of systematic reviews on the public health consequences of social isolation and loneliness","volume":"152","author":"Leigh-Hunt NB","year":"2017","journal-title":"Publ Health"},{"key":"R17-20250818","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1177\/002214650905000103","article-title":"Social disconnectedness, perceived isolation, and health among older adults","volume":"50","author":"Cornwell","year":"2009","journal-title":"J Health Soc Behav"},{"key":"R18-20250818","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1300\/J010v31n02_02","article-title":"Social support, social networks, social cohesion and health","volume":"31","author":"Berkman","year":"2000","journal-title":"Soc Work Health Care"},{"key":"R19-20250818","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1177\/0022146510395592","article-title":"Mechanisms linking social ties and support to physical and mental health","volume":"52","author":"Thoits","year":"2011","journal-title":"J Health Soc Behav"},{"key":"R20-20250818","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1177\/0309364617690394","article-title":"Factors influencing quality of life following lower limb amputation for peripheral arterial occlusive disease: a systematic review of the literature","volume":"41","author":"Davie-Smith","year":"2017","journal-title":"Prosthet Orthot Int"},{"key":"R21-20250818","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1179\/2045772312Y.0000000035","article-title":"Social networks and secondary health conditions: the critical secondary team for individuals with spinal cord injury","volume":"35","author":"Guilcher","year":"2012","journal-title":"J Spinal Cord Med"},{"key":"R22-20250818","first-page":"1","article-title":"An examination of objective social disconnectedness and perceived social isolation among persons with spinal cord injury\/dysfunction: a descriptive cross-sectional study","volume":"43","author":"Guilcher","year":"2019","journal-title":"Disabil Rehabil"},{"key":"R23-20250818","doi-asserted-by":"crossref","first-page":"175","DOI":"10.3758\/BF03193146","article-title":"*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences","volume":"39","author":"Faul","year":"2007","journal-title":"Behav Res Methods"},{"key":"R24-20250818","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1080\/0963828021000056460","article-title":"The SIGAM mobility grades: a new population-specific measure for lower limb amputees","volume":"25","author":"Ryall","year":"2003","journal-title":"Disabil Rehabil"},{"key":"R25-20250818","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1080\/10790268.2007.11753924","article-title":"Preliminary reliability and validity of a Spinal Cord Injury Secondary Conditions Scale","volume":"30","author":"Kalpakjian","year":"2007","journal-title":"J Spinal Cord Med"},{"key":"R26-20250818","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1177\/0164027504268574","article-title":"A short scale for measuring loneliness in large surveys: results from two population-based studies","volume":"26","author":"Hughes","year":"2004","journal-title":"Res Aging"},{"key":"R27-20250818","doi-asserted-by":"crossref","first-page":"1940","DOI":"10.1001\/jama.1997.03540480040036","article-title":"Social ties and susceptibility to the common cold","volume":"277","author":"Cohen","year":"1997","journal-title":"J Am Med Assoc"},{"key":"R28-20250818","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1111\/j.1559-1816.1983.tb02325.x","article-title":"Positive events and social supports as buffers of life change stress","volume":"13","author":"Cohen","year":"1983","journal-title":"J Appl Soc Psychol"},{"key":"R29-20250818","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1037\/0090-5550.40.2.95","article-title":"Body image, perceived social stigma,and the prediction of psychosocial adjustment to leg amputation","volume":"40","author":"Rybarczyk","year":"1995","journal-title":"Rehabil Psychol"},{"key":"R30-20250818","first-page":"583","article-title":"Assessment of global function: The Reintegration to Normal Living Index","volume":"69","author":"Wood-Dauphinee","year":"1988","journal-title":"Arch Phys Med Rehabil"},{"key":"R31-20250818","doi-asserted-by":"crossref","first-page":"1757","DOI":"10.1016\/j.apmr.2012.05.001","article-title":"University of Washington self-efficacy scale: a new self-efficacy scale for people with disabilities","volume":"93","author":"Amtmann","year":"2012","journal-title":"Arch Phys Med Rehabil"},{"key":"R32-20250818","doi-asserted-by":"crossref","first-page":"2559","DOI":"10.1007\/s11136-016-1300-z","article-title":"Testing the measurement invariance of the University of Washington Self-Efficacy Scale short form across four diagnostic subgroups","volume":"25","author":"Chung","year":"2016","journal-title":"Qual Life Res"},{"key":"R33-20250818","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1097\/00005650-199206000-00002","article-title":"The MOS 36-item short-form health survey (SF36). I. Conceptual framework and item selection","volume":"30","author":"Ware","year":"1992","journal-title":"Med Care"},{"key":"R34-20250818","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1038\/sc.2012.33","article-title":"Validity of the mental health subscale of the SF-36 in persons with spinal cord injury","volume":"50","author":"van Leeuwen","year":"2012","journal-title":"Spinal Cord"},{"key":"R35-20250818","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1080\/165019702760279242","article-title":"Life satisfaction in 18- to 64-year-old Swedes: in relation to gender, age, partner and immigrant status","volume":"34","author":"Fugl-Meyer","year":"2002","journal-title":"J Rehabil Med"},{"key":"R36-20250818","doi-asserted-by":"crossref","DOI":"10.1016\/j.apmr.2021.03.030","article-title":"An examination of the relationships among social networks and loneliness on health and life satisfaction in people with spinal cord injury\/dysfunction","author":"Hitzig","year":"2021","journal-title":"Arch Phys Med Rehabil"},{"key":"R37-20250818","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1111\/jan.12237","article-title":"An integrative review of self-efficacy and patient recovery post acute injury","volume":"70","author":"Connolly","year":"2014","journal-title":"J Adv Nurs"},{"key":"R38-20250818","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1016\/j.apmr.2008.08.222","article-title":"Self-management improves outcomes in persons with limb loss","volume":"90","author":"Wegener","year":"2009","journal-title":"Arch Phys Med Rehabil"},{"key":"R39-20250818","doi-asserted-by":"crossref","first-page":"e0247139","DOI":"10.1371\/journal.pone.0247139","article-title":"Interventions to reduce social isolation and loneliness during COVID-19 physical distancing measures: a rapid systematic review","volume":"16","author":"Williams","year":"2021","journal-title":"PLoS One"},{"key":"R40-20250818","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1080\/03093640802024955","article-title":"Predictors of quality of life among individuals who have a lower limb amputation","volume":"32","author":"Asano","year":"2008","journal-title":"Prosthet Orthot Int"},{"key":"R41-20250818","doi-asserted-by":"crossref","first-page":"100944","DOI":"10.1016\/j.dhjo.2020.100944","article-title":"The Covid-19 pandemic and people with disability","volume":"13","author":"Turk","year":"2020","journal-title":"Disabil Health J"}],"container-title":["Prosthetics &amp; Orthotics International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/PXR.0000000000000069","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T20:04:44Z","timestamp":1755547484000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/PXR.0000000000000069"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,14]]},"references-count":41,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.1097\/pxr.0000000000000069","relation":{},"ISSN":["0309-3646","1746-1553"],"issn-type":[{"value":"0309-3646","type":"print"},{"value":"1746-1553","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,14]]},"assertion":[{"value":"2021-02-04","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-08-09","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}