# Assessing Lower-Limb Prosthetic Users with the Trinity Amputation and Prosthesis Experience Scale-Revised: A Cross-Sectional Study

## TL;DR

This study evaluates how well lower-limb prosthetic users in Jordan adjust psychologically, their activity limitations, and prosthesis satisfaction using a validated Arabic version of the TAPES-R scale.

## Contribution

The study validates and applies the Arabic TAPES-R to assess lower-limb prosthetic users in Jordan, highlighting associations between pain and functional outcomes.

## Key findings

- Participants showed positive psychosocial adjustment and moderate prosthesis satisfaction.
- Residual and phantom limb pain were linked to higher activity restriction and lower satisfaction.
- Transfemoral amputees reported higher functional satisfaction than transtibial amputees.

## Abstract

Background: Lower limb amputation affects physical function, mental health, and body image. Rehabilitation outcomes depend on both psychological adjustment and functional performance, including mobility and prosthesis satisfaction. This study aimed to evaluate psychological adjustment, activity restriction, and prosthesis satisfaction among lower-limb prosthetic users in Jordan using the Arabic TAPES-R. Objective: To assess, using a validated tool, the psychological adjustment, activity restriction, and prosthesis satisfaction of lower-limb prosthetic users in Jordan, aligning with the study title and cross-sectional design. Methods: This cross-sectional study included 74 unilateral lower-limb prosthetic users (66.2% male, mean age 42.4 ± 13.1 years). Sociodemographic and body composition characteristics were recorded. Participants completed the Arabic TAPES-R between September 2024 and April 2025. The TAPES-R measured psychosocial adjustment, activity restriction, and prosthesis satisfaction. Data were analyzed using descriptive statistics, Cronbach’s alpha for internal consistency, independent-samples t-tests, and Pearson correlations (p < 0.05). Results: Participants demonstrated generally positive psychosocial adjustment (Psychosocial Total = 3.08 ± 0.52) and moderate prosthesis satisfaction (Total Satisfaction = 2.23 ± 0.47), with variable activity restriction (8.76 ± 5.61). Internal consistency was strong across TAPES-R subscales (α = 0.816–0.955). Functional Satisfaction was higher in those with transfemoral than transtibial amputation (p = 0.041). Psychosocial adjustment correlated positively with prosthesis satisfaction (r = 0.48, p < 0.001) and negatively with activity restriction (r = −0.52, p < 0.001). Residual limb pain (45.9%) was associated with higher activity restriction (p = 0.022), and phantom limb pain (55.4%) with lower prosthetic satisfaction (p = 0.031). Conclusions: The Arabic TAPES-R effectively identifies psychological adjustment, activity restriction, and prosthesis satisfaction in lower-limb prosthetic users in Jordan. Participants generally reported positive psychosocial adjustment and moderate prosthesis satisfaction, but functional limitations remain, particularly in those with residual or phantom limb pain. These findings support the use of the TAPES-R as a clinical and research screening tool and provide guidance for targeted rehabilitation interventions.