Better practical evaluation for lower limb amputees

Marzoug, E A; Landham, T L; Dance, C; Bamji, Andrew

doi:10.1080/0963828031000148610

Cited by 11 publications

(6 citation statements)

References 10 publications

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“…Underlying severe respiratory disease will also affect the ability of an amputee to successfully gait retrain . Chin et al .…”

Section: Resultsmentioning

confidence: 99%

“…The aim of rehabilitation in older dysvascular amputees is to restore walking ability . Many rehabilitation units use an early walking aid or interim prosthesis to reduce the risk of functional decline and determine suitability for permanent prosthesis prescription . However, for many older dysvascular amputees, wheelchair mobility might be a more appropriate goal.…”

Section: Discussionmentioning

confidence: 99%

“…In summary, there are many factors influencing successful prosthetic use in older dysvascular amputees, and identifying those that might become successful prosthesis users is difficult. 12,38,39 This patient group has a poor survival rate, with a 2-year mortality rate of 16% 40 -56% 14 and a 5-year survival of just 22.6% 3 -45%. 33 The survival of this group of patients has not changed in 40 years.…”

Section: Discussionmentioning

confidence: 99%

“…60 Many rehabilitation units use an early walking aid or interim prosthesis to reduce the risk of functional decline and determine suitability for permanent prosthesis prescription. 38,53,61 However, for many older dysvascular amputees, wheelchair mobility might be a more appropriate goal. These patients still require a period of rehabilitation to learn transfers, ADL and become wheelchair independent.…”

Section: Discussionmentioning

confidence: 99%

“…15,30,35,37 Underlying severe respiratory disease will also affect the ability of an amputee to successfully gait retrain. 26,38 Chin et al examined volume oxygen maximum (VO2 max) of dysvascular transfemoral amputees to investigate if the percentage of VO2 max, as a measure of physical fitness, is a useful predictor of successful prosthetic rehabilitation outcome (defined as the ability to walk 100 m or more independently with/without a cane). The successful group were capable of strenuous exercise, reaching an intensity of 50% VO2 max or more, compared with the non-successful group who failed to reach the intensity of 50% VO2 max.…”

Section: Agementioning

confidence: 99%

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Rehabilitation of the older vascular amputee: A review of the literature

Fleury

Salih

Peel

2012

Geriatrics Gerontology Int

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The aim was to review the literature on factors affecting prosthetic rehabilitation of older vascular lower extremity amputees. A search of the literature was carried out using the MEDLINE, EMBASE and CINAHL databases up to September 2010. Only original English language articles were accepted. Relevant studies were reviewed and selected based on prespecified inclusion criteria namely: age more than 65 years; vascular cause for the amputation; amputation level of below knee, through-the-knee or above knee; and discussed factors affecting rehabilitation. Age alone is not an absolute contraindication to prosthetic limb prescription; however, it does influence the potential success of gait retraining. Other factors influencing prosthetic fitting and use include comorbidities, premorbid function, level of amputation, status of the remaining limb and patient motivation. Prosthetic gait retraining is not possible in every older dysvascular amputee; however, almost all amputees will benefit from a rehabilitation program to increase independence in transfers and learn wheelchair skills. The MESH key words were: "aged" "diabetes complications" "peripheral vascular diseases" "amputees" "amputation" "rehabilitation" and "artificial limbs".

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“…Underlying severe respiratory disease will also affect the ability of an amputee to successfully gait retrain . Chin et al .…”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Agementioning

confidence: 99%

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Rehabilitation of the older vascular amputee: A review of the literature

Fleury

Salih

Peel

2012

Geriatrics Gerontology Int

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Racial disparities in prosthesis abandonment and mobility outcomes after lower limb amputation from a dysvascular etiology in a veteran population

Hurwitz,

Czerniecki,

Morgenroth

et al. 2024

PM&R

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BackgroundNon‐Hispanic Black (NHB) individuals have higher rates of amputation and increased risk of a transfemoral amputation due to dysvascular disease than non‐Hispanic White (NHW) individuals. However, it is unclear if NHB individuals have differences in prosthesis use or functional outcomes following an amputation.ObjectiveTo determine if there are racial disparities in prosthesis abandonment and mobility outcomes in veterans who have undergone their first major unilateral lower extremity amputation (LEA) due to diabetes and/or peripheral artery disease.DesignNational cohort study that identified individuals retrospectively through the Veterans Affairs (VA) Corporate Data Warehouse (CDW) from March 1, 2018, to November 30, 2020, then prospectively collected their self‐reported prosthesis abandonment and mobility. Multiple logistic regression was used to control for potential confounders and identify potential effect modifiers.SettingThe VA CDW, participant mailings and phone calls.ParticipantsThree hundred fifty‐seven individuals who underwent an incident transtibial or transfemoral amputation due to diabetes and/or peripheral arterial disease.InterventionsNot applicable.Main Outcomes Measures(1) Self‐reported prosthesis abandonment. (2) Level of mobility assessed using the Locomotor Capabilities Index.ResultsRurally located NHB individuals without a major depressive disorder (MDD) had increased odds of abandoning their prosthesis (adjusted odds ratios [aOR] = 5.3; 95% confidence interval [CI]: [1.3–21.1]). This disparity was nearly three times as large for rurally located NHB individuals with MDD diagnosis, compared with other races from rural areas and with MDD (aOR = 15.8; 95% CI, 2.5–97.6). NHB individuals living in an urban area were significantly less likely to achieve advanced mobility, both with MDD (aOR=0.16; 95% CI: [0.04–7.0]) and without MDD (aOR = 0.26; 95% CI: [0.09–0.73]).ConclusionsThis study demonstrated that health care disparities persist for NHB veterans following a dysvascular LEA, with increased prosthesis abandonment and worse mobility outcomes.

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