Smart Solutions for Veterans: Enhancing Amputee Self-Care through Mobile Technology

Ali Khatib, Leila Gholamhosseini, Mahboobeh Afzali, Iman Nikkhoo, Victor Lami



Introduction: Disability arising from amputation is intricately shaped by both social factors and rehabilitative care. The efficacy of veterans' self-care emerges as a pivotal factor in effectively managing, controlling, and reducing complications, thereby augmenting and enriching their overall quality of life. This research delves into the creation, execution, and assessment of a comprehensive self-care software tailored for amputees, with a focus on harnessing the practical utility of smartphones and their manifest capabilities in the realm of healthcare.

Material and Methods: In 2023, an applied developmental study was conducted, encompassing the evaluation, design, development, implementation, and assessment of a mobile application dedicated to the self-care management of veterans with amputations. The mobile application's conception unfolded within the Android Studio environment, utilizing the Java programming language within the Android operating system. A user interface satisfaction questionnaire was used to gauge the app's usability, with feedback from 20 veterans experiencing amputations.

Results: The needs assessment for a comprehensive self-care software tailored for amputation veterans identified requisites across four distinct sectors. Building upon these insights, a holistic self-care software solution was meticulously designed. Evaluating usability and user satisfaction revealed that veterans rated the app at a "good" level, with an average score of 7.88±1.03 (out of 9).

Conclusion: The mobile application proved apt in content, functionality, and quality, presenting a valuable tool for enhancing the lifestyle, education, and self-care practices of veterans with amputations. This conclusion stems from a thorough usability evaluation from the end-users' perspective.


Self-Care; Mobile Applications; Veterans; Amputation;


Leonard C, Sayre G, Williams S, Henderson A, Norvell D, Turner AP, et al. Understanding the experience of veterans who require lower limb amputation in the veterans health administration. PLoS One. 2022; 17(3): e0265620. PMID: 35303030 DOI: 10.1371/journal.pone.0265620

Resnik L, Borgia M, Heinemann AW, Clark MA. Prosthesis satisfaction in a national sample of veterans with upper limb amputation. Prosthet Orthot Int. 2020; 44(2): 81-91. PMID: 31960734 DOI: 10.1177/0309364619895201

Hobusch GM, Döring K, Brånemark R, Windhager R. Advanced techniques in amputation surgery and prosthetic technology in the lower extremity. EFORT Open Rev. 2020; 5(10): 724-41. PMID: 33204516 DOI: 10.1302/2058-5241.5.190070

Ebrahimzadeh MH, Rajabi MT. Long-term outcomes of patients undergoing war-related amputations of the foot and ankle. J Foot Ankle Surg. 2007; 46(6): 429-33. PMID: 17980838 DOI: 10.1053/j.jfas.2007.08.011

Shojaei H, Soroush MR, Modirian E, Gholizadeh H. An evaluation of osteoporosis prevalence in spinal cord disabled veterans. Daneshvar Medicine. 2007; 14(66): 37-44.

Kaufmann JJ, McMenemy L, Phillips AT, McGregor AH. Bone health in lower-limb amputees. In: Bull AMJ, Clasper J, Mahoney PF (Eds). Blast injury science and engineering: A guide for clinicians and researchers. Springer; 2023.

Johnson CC, Loeffler BJ, Gaston RG. Targeted muscle reinnervation: a paradigm shift for neuroma management and improved prosthesis control in major limb amputees. J Am Acad Orthop Surg. 2021; 29(7): 288-96. PMID: 33405489 DOI: 10.5435/JAAOS-D-20-00044

Finco M, Kim S, Ngo W, Menegaz RA. A review of musculoskeletal adaptations in individuals following major lower-limb amputation. J Musculoskelet Neuronal Interact. 2022; 22(2): 269-83. PMID: 35642706 PMCID: PMC9186459

Gunterstockman BM, Russell Esposito E, Yoder A, Smith C, Farrokhi S. Weight changes in young service members after lower limb amputation: Insights from group-based trajectory modeling. Mil Med. 2023; 188(9-10): e2992-9. PMID: 36883993 DOI: 10.1093/milmed/usad062

Christensen J, Ipsen T, Doherty P, Langberg H. Physical and social factors determining quality of life for veterans with lower-limb amputation(s): A systematic review. Disabil Rehabil. 2016; 38(24): 2345-53. PMID: 26985705 DOI: 10.3109/09638288.2015.1129446

Masoudi R, Mohammadi I, Nabavi S, Ahmadi F. The effect of Orem based self-care program on physical quality of life in multiple sclerosis patients. Shahrekord University of Medical Sciences Journal. 2008; 10(2): 21-8.

Delgado C. Sense of coherence, spirituality, stress and quality of life in chronic illness. J Nurs Scholarsh. 2007; 39(3): 229-34. PMID: 17760795 DOI: 10.1111/j.1547-5069.2007.00173.x

Elnaggar A, Ta Park V, Lee SJ, Bender M, Siegmund LA, Park LG. Patients’ use of social media for diabetes self-care: Systematic review. J Med Internet Res. 2020; 22(4): e14209. PMID: 32329745 DOI: 10.2196/14209

Webber D, Guo Z, Mann S. Self-care in health: We can define it, but should we also measure it? Self Care Journal. 2013; 4(5): 101-6.

Goodall RJ, Ellauzi J, Tan MK, Onida S, Davies AH, Shalhoub J. A systematic review of the impact of foot care education on self-efficacy and self-care in patients with diabetes. Eur J Vasc Endovasc Surg. 2020; 60(2): 282-92. PMID: 32660807 DOI: 10.1016/j.ejvs.2020.03.053

Lindenfeld J, Albert NM, Boehmer JP, Collins SP, Ezekowitz JA, Givertz MM, et al. HFSA 2010 comprehensive heart failure practice guideline. J Card Fail. 2010; 16(6): e1-194. PMID: 20610207 DOI: 10.1016/j.cardfail.2010.04.004

Nasi G, Cucciniello M, Guerrazzi C. The role of mobile technologies in health care processes: The case of cancer supportive care. J Med Internet Res. 2015; 17(2): e26. PMID: 25679446 DOI: 10.2196/jmir.3757

Cano Martín JA, Martínez-Pérez B, de la Torre- Díez I, López-Coronado M. Economic impact assessment from the use of a mobile app for the self-management of heart diseases by patients with heart failure in a Spanish region. J Med Syst. 2014; 38(9): 96. PMID: 24994514 DOI: 10.1007/s10916-014-0096-z

Inglis SC, Clark RA, Dierckx R, Prieto-Merino D, Cleland JGF. Structured telephone support or noninvasive telemonitoring for patients with heart failure. Cochrane Database Syst Rev. 2015; 2015(10): CD007228. PMID: 26517969 DOI: 10.1002/14651858.CD007228.pub3

Kirwan M. Developing and evaluating smarphone applications to improve health behaviours and chronic disease self-management [PhD Thesis]. Queensland: Central Queensland University; 2012.

Ayatollahi H, Hasannezhad M, Saneei Fard H, Kamkar Haghighi M. Type 1 diabetes self-management: Developing a web-based telemedicine application. Health Inf Manag. 2016; 45(1): 16-26. PMID: 28691565 DOI: 10.1177/1833358316639456

Zerehsaz M, Fattahi R, Davarpanah M. Investigation and analysis of elements and features discussed in the Simorgh user interface software and determine students' satisfaction from interacting with this user interface. Library and Information Science. 2006; 9(4): 127-50.

Asghari F, Sayadi A, Saadat S, Rashidi E. Prioritizing the needs of Guilan province's less than 25% veterans from the viewpoint of them and their spouses. Iranian Journal of War and Public Health. 2015; 7(3): 133-8.

Fiordelli M, Diviani N, Schulz PJ. Mapping mHealth research: A decade of evolution. J Med Internet Res. 2013; 15(5): e95. PMID: 23697600 DOI: 10.2196/jmir.2430

Katibeh M, Kalantarion M, Sabbaghi H, Mousavi B, Schriver M, Nikkhah H, et al. Designing a screening program for prevention of avoidable blindness in Iran through a participatory action approach. J Ophthalmic Vis Res. 2019; 14(1): 52-61. PMID: 30820288 DOI: 10.4103/jovr.jovr_43_18

Rajavi Z, Katibeh M, Ziaei H, Fardesmaeilpour N, Sehat M, Ahmadieh H, et al. Rapid assessment of avoidable blindness in Iran. Ophthalmology. 2011; 118(9): 1812-8. PMID: 21571371 DOI: 10.1016/j.ophtha.2011.01.049

Katibeh M, Blanchet K, Akbarian S, Hosseini S, Ahmadieh H, Burton MJ, et al. Planning eye health services in Varamin district, Iran: A cross-sectional study. BMC Health Serv Res. 2015; 15: 140. PMID: 26021828 DOI: 10.1186/s12913-015-0797-0

Castelnuovo G, Zoppis I, Santoro E, Ceccarini M, Pietrabissa G, Manzoni GM, et al. Managing chronic pathologies with a stepped mHealth-based approach in clinical psychology and medicine. Front Psychol. 2015; 6: 407. PMID: 25926801 DOI: 10.3389/fpsyg.2015.00407

Garabedian LF, Ross-Degnan D, Wharam JF. Mobile phone and smartphone technologies for diabetes care and self-management. Curr Diab Rep. 2015; 15(12): 109. PMID: 26458380 DOI: 10.1007/s11892-015-0680-8

Gaunaurd I, Gailey R, Springer B, Symsack A, Clemens S, Lucarevic J, et al. The effectiveness of the DoD/VA mobile device outcomes-based rehabilitation program for high functioning service members and veterans with lower limb amputation. Mil Med. 2020; 185(Suppl 1): 480-9. PMID: 32074320 DOI: 10.1093/milmed/usz201

Iraji Noghondar R, Poorsoltani Zarandi H. Determining of validity and reliability of basic needs satisfaction in sport scale in the veterans and the disables athlete. Sport Management Studies. 2016; 8(37): 219-36.

Foroughzadeh S, Shariati Mazinani S. Identifying and ranking the needs of veterans under 25%: A case study in Khorasan Razavi province, Iran. Iranian Journal of Isaar Studies. 2020; 1(2): 93-100.

Ghazisaeedi M, Shahmoradi L, Ranjbar A, Sahraei Z, Tahmasebi F. Designing a mobile-based self-care application for patients with heart failure. Journal of Health and Biomedical Informatics. 2016; 3(3): 195-204.

Sheikhtaheri A, Norouzi E, Sadoughi F. Developing a mobile-based self-care application for patients with breast cancer undergoing chemotherapy. Journal of Health Administration. 2019; 22(4): 35-49.

Hoevenaars D, Holla JF, Te Loo L, Koedijker JM, Dankers S, Houdijk H, et al. Mobile app (WHEELS) to promote a healthy lifestyle in wheelchair users with spinal cord injury or lower limb amputation: Usability and feasibility study. JMIR Form Res. 2021; 5(8): e24909. PMID: 34379056 DOI: 10.2196/24909

Vandelanotte C, Spathonis KM, Eakin EG, Owen N. Website-delivered physical activity interventions a review of the literature. Am J Prev Med. 2007; 33(1): 54-64. PMID: 17572313 DOI: 10.1016/j.amepre.2007.02.041

Gilliland J, Sadler R, Clark A, O'Connor C, Milczarek M, Doherty S. Using a smartphone application to promote healthy dietary behaviours and local food consumption. Biomed Res Int. 2015; 2015: 841368. PMID: 26380298 DOI: 10.1155/2015/841368

Wang JB, Cadmus-Bertram LA, Natarajan L, White MM, Madanat H, Nichols JF, et al. Wearable sensor/device (Fitbit One) and SMS text-messaging prompts to increase physical activity in overweight and obese adults: A randomized controlled trial. Telemed J E Health. 2015; 21(10): 782-92. PMID: 26431257 DOI: 10.1089/tmj.2014.0176



  • There are currently no refbacks.