"If I can do it I will do it, if I can't, I can't": a study of adaptive self-regulatory strategies following lower limb amputation.

PURPOSE To explore the goal-related strategies employed by people following lower limb amputation using a framework based on the dual-process model of adaptive self-regulation. METHODS Semi-structured interviews were conducted with 30 individuals with a lower limb amputation. RESULTS Theoretical thematic analysis identified four broad assimilative/goal pursuit strategies; internal resource use, planning, technology use and help use. The most common strategies were maintaining a specific leisure activity (n=20), seeking instrumental help (n=15) and determination (n=15). Three broad categories of accommodative/goal adjustment strategies were also identified; interpersonal accommodation, managing limitations and meaning-making. The most common were accepting limitations (n=18), emotional support from friends and family (n=17) and adjusting goals to constraints (n=16). There was also evidence of strategies that combined the use of accommodative and assimilative strategies, and the use of avoidant strategies. CONCLUSIONS The findings point towards key assimilative/goal pursuit and accommodative/goal adjustment strategies that may be adaptive following lower limb amputation. The study highlights the potential usefulness of the dual-process model in understanding how individuals adapt to functional disability, while bringing to light issues warranting further explication within this framework. Implications for Rehabilitation People adopt specific adaptive goal pursuit and goal adjustment strategies in response to goal disruptions following limb loss. Being aware of the processes involved in regulating goals in response to challenges is useful for understanding adjustment to limb loss. Greater understanding of adaptive and maladaptive goal strategies may help the rehabilitation team to foster positive outcomes in people with lower limb amputation.