Baylor Researcher Seeks to Improve Quality of Life for Growing Amputee Population
According to a 2024 study, more than 2.3 million Americans are currently living with limb loss—and this number is only growing. Roland J. Paquette, PhD, PA-C, Clinical Associate Professor and Director of Outcomes and Assessment in Baylor University’s Physician Assistant Studies (PA) program, shares that the number of amputations is growing by around 25% each year.
“It’s largely related to chronic diseases like diabetes and vascular disease,” he said. “Right now, the estimates are that about 1 million people have a lower extremity amputation of some sort.”
As the number of amputations increases, the need for solutions to improve quality of life for these individuals is also magnified. This is where Paquette’s research comes in. His focus? Optimizing outcomes related to prosthesis use after amputation.
“If we can maximize an individual’s prosthesis usage—whether it’s upper extremity or lower extremity—in theory, we can increase their quality of life, if that’s the point of the prosthetic device. It’s there to augment life, to be used as a tool—if the person chooses to use it,” he shared.
As a former Special Forces Medical Sergeant for the U.S. Army, much of Paquette’s work is tied to the military community; however, he also looks to translate his findings to a more general population. For example, Paquette explained how the effects of a sedentary lifestyle can be compounded by amputation. If a chronic disease emerged due to a lack of physical activity, leading to an amputation, then exercise becomes even more challenging for that individual with the loss of mobility.
“We have found that, amongst amputees, there are increased rates of chronic diseases occurring after the fact,” he shared. “So if we can figure out how to maximize prosthesis usage by finding out what the barriers to usage are and potentially alleviating those, then we can maybe increase physical activity.”
Paquette is also exploring a connection between residual limb pain, prosthesis usage, and resiliency. He and his team of researchers have found, through a long-term study, that those who experienced pain while using a prosthetic device had an increased chance of stopping usage during the first 33 months. However, from 33 to 100 months, those still using a prosthetic device, and experiencing pain, were more likely to utilize their device.
“What’s interesting is that these individuals acknowledge that the pain is present,” he explained. “In medicine, we think about pain as being the enemy. We want to minimize pain. We want to eliminate pain. In the amputation rehabilitation space, it’s very difficult to eliminate pain.
“So the question becomes, potentially, should we be putting our resources into eliminating pain? Is that even possible? Or should we be figuring out what it is about some individuals that allows them to accommodate the pain and others to not?”
As a bilateral transfemoral amputee himself who utilizes prostheses to walk, this research is personal for Paquette. Determined not to become “pigeon-holed,” he was originally disinterested in prosthetics-related research. Eventually though, Paquette realized that his intimate knowledge of amputation and prosthetics, along with his participation in the amputee community, served as an inspiration for research theories and potential projects. He does also note the dark side of his firsthand knowledge—the potential for bias and shading outcomes based on his own familiarity with the experience.
“It can be a double-edged sword, which is why research is a team event,” he said. “We’re all individuals. We look at things from our own perspective, which can be invaluable, but we also have to be careful about removing our biases.”
Paquette joined Baylor’s Physician Assistant Studies program faculty in May 2024 and is looking forward to welcoming the first cohort of PA students this fall. Even as he begins teaching, his research in this important and growing area of need will continue—an example and inspiration to his students of impact-focused discovery seeking to solve the world’s challenges and improve quality of life.
ABOUT ROBBINS COLLEGE OF HEALTH AND HUMAN SCIENCES AT BAYLOR UNIVERSITY
Established in 2014, Robbins College of Health and Human Sciences seeks to enhance health, quality of life, and human flourishing for all individuals and communities through education, research, and innovation. It includes six academic departments—Communication Sciences and Disorders; Health, Human Performance, and Recreation; Human Sciences and Design; Occupational Therapy; Physical Therapy; and Public Health—along with the Division of Health Professions, which houses the Master of Physician Assistant Studies program. Robbins College offers 13 bachelor’s degrees, eight master’s degrees, and six doctoral degrees, as well as nine graduate programs in partnership with the U.S. Army. Graduate programs in Robbins College are offered in a variety of modalities, including on campus, online, and hybrid.