Publication year
2010
Citation Title
Service members and Veterans with major traumatic limb loss from Vietnam War and OIF/OEF conflicts: Survey methods, participants, and summary findings.
Journal Name
Journal of Rehabilitation Research and Development
Journal Volume
47
Issue Number
4
Page Numbers
275-298
DOI
10.1682/jrrd.2010.01.0009
Summary
A sample of 298 Vietnam and 283 Iraq and Afghanistan Service members/Veterans who sustained major traumatic limb loss during combat completed a self-report survey about their injuries, mental and physical health, quality of life, and their use and satisfaction with a prosthetic device. Health status was rated as good to excellent for a vast majority of respondents; most reported that they could cope with and had successfully adjusted to life with their prostheses.
Key Findings
The 298 Vietnam Veteran participants lost 378 limbs on average 38.6 years prior to the study. The 283 OIF/OEF participants lost 351 limbs on average 3.1 years prior.
Overall good to excellent health status was reported by 71% of the Vietnam and 86% of the OIF/OEF participants.
Ninety-three percent of the Vietnam and 97% of the OIF/OEF prostheses users report that they can cope with their prostheses; 94% report adjusting successfully to life with a prosthesis.
Twenty-one percent of OIF/OEF participants returned to Active Duty status after the injury.
Implications for Program Leaders
Offer supportive services to assist military families in understanding and coping with the challenges associated with limb loss
Provide concrete information on normative versus problematic children's responses to having a parent who have experienced loss of a limb
Host support groups for Service members who have phantom pain, residual limb and back pain, and skin problems
Implications for Policy Makers
Continue to support prostheses development and Service members rehabilitation to improve physical and mental health, mobility, and quality of life
Continue to support programs that address the unique challenges faced by deployed Service members with physical injuries and loss of limbs
Recommend education for service providers around the possible effects of deployment on Service members’ families
Methods
A group of rehabilitation and surgery clinicians developed the survey to address key issues for Veterans and Service members with major upper- and lower-limb loss.
Five hundred-one Vietnam and 541 Iraq or Afghanistan Veterans with major traumatic limb loss were identified to participate; 65% of the Vietnam and 59% of the OIF/OEF Veterans that were contacted agreed to participate.
Participants were invited to participate via mail; they could complete the survey online, via telephone, or on paper.
Demographic information, combat-associated injuries, mental and physical health status, prosthetic and assistive device use and satisfaction, and service utilization were assessed.
Participants
Two hundred ninety-eight Vietnam and 283 OIF/OEF Veterans with major limb loss due to participation in combat theater were included in the study.
The following are details on the Vietnam cohort: mean age was 60.7 years (SD = 3); 100% were male; and 81% were White, 9% were Black, and 7% were Latino.
The following are details on the OIF/OEF cohort: mean age was 29.3 years (SD = 5.8); 97% were male; and 73% were White, 10% were Black, and 9% were Latino/Latina.
Limitations
Responders may have been at higher functioning levels than those who did not respond which may have influenced the outcomes of this study.
Participants who chose to respond via mail, telelphone, or online may have differed in important ways, which was not accounted for in the analyses.
Recall, particularly for the Vietnam participants, may have been impaired due to time since injury and associated traumas or head injuries.
Avenues for Future Research
Explore in more detail the challenges experienced by Service members with phantom pain, residual limb and back pain, and skin disorders
Gather data from spouses/partners of Service members with traumatic limb loss to elucidate their experience in dealing with Service members' loss of limb and associated challenges
Conduct studies about how loss of limbs impact Service members' and their spouses' interest in leaving military service
Focus
Multiple Branches
Target Population
Population Focus
Military Branch
Military Component
Abstract
Care of veterans and servicemembers with major traumatic limb loss from combat theaters is one of the highest priorities of the Department of Veteran Affairs. We achieved a 62% response rate in our Survey for Prosthetic Use from 298 Vietnam war veterans and 283 servicemembers/veterans from Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) who sustained major traumatic limb loss. Participants reported their combat injuries; health status; quality of life; and prosthetic device use, function, rejection, and satisfaction. Despite the serious injuries experienced, health status was rated excellent, very good, or good by 70.7% of Vietnam war and 85.5% of OIF/OEF survey participants. However, many health issues persist for Vietnam war and OIF/OEF survey participants (respectively): phantom limb pain (72.2%/76.0%), chronic back pain (36.2%/42.1%), residual-limb pain (48.3%/62.9%), prosthesis-related skin problems (51.0%/58.0%), hearing loss (47.0%/47.0%), traumatic brain injury (3.4%/33.9%), depression (24.5%/24.0%), and posttraumatic stress disorder (37.6%/58.7%). Prosthetic devices are currently used by 78.2% of Vietnam war and 90.5% of OIF/OEF survey participants to improve function and mobility. On average, the annual rate for prosthetic device receipt is 10.7-fold higher for OIF/OEF than for Vietnam war survey participants. Findings from this cross-conflict survey identify many strengths in prosthetic rehabilitation for those with limb loss and several areas for future attention.
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