Mobility and postural limitations perceived by transtibial amputees undertaking agricultural activities: a qualitative study

PURPOSE: In Colombia, 98% of landmines occur in rural areas, where the main victims of amputation are farmers. The challenges these amputees face in their agricultural work remain unknown. The aim of this study is to determine the mobility and postural limitations these farmers face in carrying out their daily activities. METHOD: Forty-nine participants meeting the following criteria were interviewed: transtibial amputee, 18 years and over, performs agricultural labour and wears the prosthesis daily. Subsequently, the interview transcripts were subjected to a content conventional analysis and responses were organized according to the abstraction process to identify categories and subcategories of the problems. RESULTS: Main problems reported were walking on sloping, uneven and wet terrain, problems associated with the stump skin, squatting, kneeling, using vehicles or animals for transportation and carrying objects over 30 kg. Postures such as sitting, running, jumping, and standing on tiptoes were mentioned less frequently. CONCLUSIONS: In conclusion, the prostheses worn by transtibial amputee farmers are not suitable for working on sloping and uneven terrain, nor for performing postures such as kneeling or squatting. These postures are very common in agricultural and livestock tasks in countries with mountainous areas such as Latin American countries. The recognition of problems reported by farmers transtibial amputees, may help to improve the design of prostheses so that they meet the needs of this population and decrease secondary injuries associated with prosthetic use. This information is useful to identify compensatory postures that facilitate prosthetic adaptation and rehabilitation for amputees.