Development of a scoring tool (BLARt score) to predict functional outcome in lower limb amputees

Abstract

In the patient cohorts studied, the BLARt assessment tool was a strong predictor of whether or not patients would be able to walk with a prosthetic limb after surgery. It is simple to administer and could be useful in clinical practice to inform expectations for patients and clinicians. Implications for rehabilitation Patients undergoing lower limb amputation face major physical and psychological challenges after surgery that have a considerable impact on rehabilitation and their ability to walk independently. Many amputees are unable to walk with a prosthetic limb, but there are no validated tools to predict this before surgery. The BLARt is a potentially valuable measure that can predict the likelihood of being unable to walk after amputation. It is simple to use and could be useful to inform patients' and clinicians' expectations before surgery.

A Systematic Review and Narrative Synthesis of Risk Prediction Tools Used to Estimate Mortality, Morbidity, and Other Outcomes Following Major Lower Limb Amputation

“…23,24 The two remaining studies were the only ones to develop a new tool and conduct external validation. 25,26 All but two studies were published in the past 10 years and, therefore, given the small number of studies, no attempt was made to try and compare tools developed at different times.…”

“…Nine tools provided risk estimations for mortality, 15e17,19e 21,23,24,26 two tools provided post-operative morbidity predictions, 15,23 two for ambulation, 22,25 and one for reamputation to the same or higher level (i.e., TT to TF). 18 No tools were identified to predict QoL or wound healing.…”

Through-knee versus above-knee amputation for vascular and non-vascular major lower limb amputations

“…In order to use a prosthesis safely and e ectively, following above-knee amputation, the individual must have su icient cardiovascular fitness and strength, good balance and dexterity, and good cognitive function. Achieving prosthetic ambulation, therefore, becomes more challenging with age (Bowrey 2018). In addition, the above-knee amputation prosthesis is not comfortable to sit in.…”

“…If a person spends more time sitting than they do standing and mobilising, they will most likely abandon their prosthesis in favour of their wheelchair. For these reasons, prosthetic fitting post above-knee amputation is not always appropriate in the geriatric population (Bowrey 2018;Davies 2003).…”

Results of wheelchair skills training among the disabled persons with lower limb loss of vascular origin

“…Однако протезирование не всегда гарантирует функциональную подвижность и не всегда может быть самым оптимальным средством передвижения после ампутации [14]. Зачастую лица с ампутированными конечностями не могут ходить на протезах [15]; в некоторых случаях более эффективным будет использование кресла-коляски или костылей [16].…”