Daily steps and stepping cadence increase one-year following prosthesis osseointegration in people with lower-limb amputation

Gaffney, Brecca M.M.; Davis-Wilson, Hope; Awad, Mohamed E.; Tod, James; Melton, Danielle H; Lev, Guy; Stoneback, Jason W; Christiansen, Cory L.

doi:10.1080/09638288.2023.2200036

Cited by 4 publications

(2 citation statements)

References 31 publications

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“…Mobility has been previously reported to be strongly positively correlated with general satisfaction and HRQoL in individuals with lower-limb prostheses ( 89 ). Improvements in mobility are further supported by other studies on BAP users who reported a higher daily step count and daily stepping time when assessing mobility in daily activities, i.e., not in a controlled lab setting ( 90 ). In addition, even those with bilateral transfemoral BAP after on average 7 years reported improved mobility ( 91 ).…”

Section: Discussionsupporting

confidence: 64%

Bone-anchored prostheses for transfemoral amputation: a systematic review of outcomes, complications, patient experiences, and cost-effectiveness

Rehani,

Stafinski,

Round

et al. 2024

Front. Rehabil. Sci.

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IntroductionBone-anchored prostheses (BAP) are an advanced reconstructive surgical approach for individuals who had transfemoral amputation and are unable to use the conventional socket-suspension systems for their prostheses. Access to this technology has been limited in part due to the lag between the start of a new procedure and the availability of evidence that is required before making decisions about widespread provision. This systematic review presents as a single resource up-to-date information on aspects most relevant to decision makers, i.e., clinical efficacy, safety parameters, patient experiences, and health economic outcomes of this technology.MethodsA systematic search of the literature was conducted by an information specialist in PubMed, MEDLINE, Embase, CINAHL, Cochrane Library, the Core Collection of Web of Science, CADTH's Grey Matters, and Google Scholar up until May 31, 2023. Peer-reviewed original research articles on the outcomes of clinical effectiveness (health-related quality of life, mobility, and prosthesis usage), complications and adverse events, patient experiences, and health economic outcomes were included. The quality of the studies was assessed using the Oxford Centre for Evidence-Based Medicine Levels of Evidence and ROBINS-I, as appropriate.ResultsFifty studies met the inclusion criteria, of which 12 were excluded. Thirty-eight studies were finally included in this review, of which 21 reported on clinical outcomes and complications, 9 case series and 1 cohort study focused specifically on complications and adverse events, and 2 and 5 qualitative studies reported on patient experience and health economic assessments, respectively. The most common study design is a single-arm trial (pre-/post-intervention design) with varying lengths of follow-up.DiscussionThe clinical efficacy of this technology is evident in selected populations. Overall, patients reported increased health-related quality of life, mobility, and prosthesis usage post-intervention. The most common complication is a superficial or soft-tissue infection, and more serious complications are rare. Patient-reported experiences have generally been positive. Evidence indicates that bone-anchored implants for prosthesis fixation are cost-effective for those individuals who face significant challenges in using socket-suspension systems, although they may offer no additional advantage to those who are functioning well with their socket-suspended prostheses.

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Section: Discussionsupporting

confidence: 64%

Bone-anchored prostheses for transfemoral amputation: a systematic review of outcomes, complications, patient experiences, and cost-effectiveness

Rehani,

Stafinski,

Round

et al. 2024

Front. Rehabil. Sci.

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“…Several studies have indicated that patients who underwent implantation of an osseointegrated BAL show improved functional ability 53 , balance 54 , activity levels 55 , and overall quality of life 50,[56][57][58][59][60] as compared to their baseline status with socket prosthesis. There is no consensus, however, on the PROMs that are used to evaluate these patients' perspectives.…”

Section: Discussionmentioning

confidence: 99%

How Comprehensive and Efficient Are Patient-Reported Outcome Measures for Individuals with Lower Extremity Amputation Undergoing Implantation of Osseointegrated Bone Anchored Limbs?

Awad,

Melton,

Shaw

et al. 2024

JBJS Reviews

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» Patient-reported outcome measures (PROMs) are essential for measuring quality and functional outcomes after implantation of osseointegrated bone anchored limbs for patients with lower extremity amputation.» Using a novel assessment criterion with 8 domains, this study assessed all commonly used PROMs for their efficiency and comprehensiveness.» Comprehensiveness was scored according to the presence or absence of PROM questions related to these 8 domains (maximum score = 60): mobility (15 items), prosthesis (14 items), pain (10 items), psychosocial status (10 items), independence/self-care (4 items), quality of life/satisfaction (4 items), osseoperception (1 item), general information (1 item), and vitality (1 item).» The efficiency scores were calculated by dividing the comprehensiveness score by the total number of questions answered by the patients with higher scores being deemed more efficient.» The most comprehensive PROMs were Orthotics and Prosthetics User's Survey-Lower Extremity Functional Status (OPUS-LEFS) (score = 36), Prosthesis Evaluation Questionnaire (PEQ) (score = 31), and Questionnaire for Persons with a Transfemoral Amputation (score = 27).» The most efficient PROMs were the OPUS-LEFS (score = 1.8) and European Quality of Life (score = 1.4).

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Lumbopelvic movement coordination during walking improves with transfemoral bone anchored limbs: Implications for low back pain

Gaffney,

Thomsen,

Leijendekkers

et al. 2024

Gait & Posture

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Daily steps and stepping cadence increase one-year following prosthesis osseointegration in people with lower-limb amputation

Cited by 4 publications

References 31 publications

Bone-anchored prostheses for transfemoral amputation: a systematic review of outcomes, complications, patient experiences, and cost-effectiveness

Bone-anchored prostheses for transfemoral amputation: a systematic review of outcomes, complications, patient experiences, and cost-effectiveness

How Comprehensive and Efficient Are Patient-Reported Outcome Measures for Individuals with Lower Extremity Amputation Undergoing Implantation of Osseointegrated Bone Anchored Limbs?

Lumbopelvic movement coordination during walking improves with transfemoral bone anchored limbs: Implications for low back pain

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