Self-Efficacy and Social Support are Associated with Disability for Ambulatory Prosthesis Users After Lower-Limb Amputation.

Because this was a cross-sectional study, it cannot show that self-efficacy or social support caused lower disability, or that changing them would change disability over time. The sample included only people who could walk independently with a prosthesis at least 1 year after amputation, was predominantly men, and averaged 62.5 ± 8 years old with six comorbid conditions on average, so findings may not apply to non-prosthesis users, people earlier after amputation, women, or less medically complex patients. The minimally clinically important difference for WHODAS 2.0 in people with lower-limb amputation is not established, so it is unclear whether the explained variability or score differences are clinically meaningful. The motivation measure was a modified contemplation ladder not specifically validated for prosthesis users after lower-limb amputation, so the null motivation finding may reflect measurement limits. The study used perceived functional capacity rather than performance-based tests, and did not include other possible factors such as resilience.

The supplied text does not include an author conflict-of-interest declaration. The article's publication types indicate NIH extramural and non-U.S. government research support.

Do not conclude that improving self-efficacy or social support will reduce disability. This was a cross-sectional study of ambulatory prosthesis users at least 1 year after amputation, so it reports association at one time point, not a treatment effect.