02841nas a2200457   4500000000100000008004100001260000900042653003100051653001500082653001000097653002500107653002600132653002100158653001100179653002200190653001100212653001200223653000900235653001600244653001900260653002400279653002000303653003900323653002500362653002800387653002500415653002600440653001600466100001500482700001200497700001300509700001200522700001400534700001300548700001700561245017600578300001100754490000700765520159700772022001402369       2011                            d  c201110aActivities of Daily Living10aAdolescent10aAdult10aAnalysis of Variance10aDisability Evaluation10aDisabled Persons10aFemale10aFollow-Up Studies10aHumans10aleprosy10aMale10aMiddle Aged10aMotor Activity10aProspective Studies10aQuality of Life10aReconstructive Surgical Procedures10aRecovery of Function10aSickness Impact Profile10aSocial Participation10aSocioeconomic Factors10aYoung Adult1 aVan Veen N1 aHemo DA1 aBowers R1 aPahan D1 aNegrini J1 aVelema J1 aRichardus JH00aEvaluation of activity limitation and social participation, and the effects of reconstructive surgery in people with disability due to leprosy: a prospective cohort study.  a667-740 v333 a<p><strong>PURPOSE: </strong>To assess how activity limitation and social participation of individuals with leprosy-related disability change over time, and to quantify the effect of reconstructive surgery.</p>

<p><strong>METHOD: </strong>Individuals with disability due to leprosy who accepted invitations for assessment at a leprosy clinic between March and July 2007 were interviewed using the SALSA Scale (measuring activity limitation) and the Participation Scale (assessing social participation). All participants were offered reconstructive surgery. Follow-up interviews were done 1 year after the first interview or 1 year after surgery. The main outcomes were changes in SALSA score and Participation score. We used analysis of variance to identify the effects of independent factors on mean SALSA and Participation scores.</p>

<p><strong>RESULTS: </strong>We interviewed 222 participants, 15 of whom took up the offer of surgery and 207 who did not. Comparison of SALSA Scale scores at baseline and 1 year revealed that activity limitation did not significantly change over time in individuals who declined surgery; however, participants who had surgery showed a significant improvement at 1 year (p &lt; 0.001). Social participation improved over time in both groups, but the difference was significant only in the non-surgery group (p &lt; 0.001).</p>

<p><strong>CONCLUSIONS: </strong>The findings suggest that reconstructive surgery has beneficial effects on functioning. Evaluation of the need for, and effect of, surgery in larger studies is recommended.</p>
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