Evidence-Based Amputee Rehabilitation: a Systematic Approach to the Restoration of Function in People with Lower Limb Loss

Gailey, Robert; Kirk-Sanchez, Neva; Clemens, Sheila; Symsack, Allison; Gaunaurd, Ignacio

doi:10.1007/s40141-021-00335-2

Cited by 6 publications

(6 citation statements)

References 62 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The benefits of rehabilitation interventions postamputation have been well established in the literature. [50][51][52][53][54][55][56] For example, Evidence-Based Amputee Rehabilitation, standardized functional prosthetic gait training, physiotherapy protocols focusing on core strengthening, prosthesis adaptation, functional independence, and other patient-specific exercise programs have demonstrated improvements in functional mobility, balance, gait symmetry, and/or temporal spatial gait parameters. Yet differences in prosthetic gait training and rehabilitation between people with lower limb amputation using BAP and SP have not been fully explored.…”

Section: Discussionmentioning

confidence: 99%

Comparison of prosthetic mobility and balance in transfemoral amputees with bone-anchored prosthesis vs. socket prosthesis

Gailey

Kristal

Muderis

et al. 2022

Prosthetics &Amp; Orthotics International

Self Cite

View full text Add to dashboard Cite

Background:The literature comparing bone-anchored prosthesis (BAP) with socket prosthesis (SP) consistently reports improvement in physical health and quality of life using primarily patient-reported outcome measures (PROMs).Objective:To determine the differences in mobility and balance using performance-based outcome measures and PROMs in people with transfemoral amputations (TFAs) fitted with BAP vs. SP.Study design:Causal comparative.Methods:Two groups of people with TFAs were recruited: one using a BAP (N = 11; mean age ± standard deviation, 44 ± 14.9 years; mean residual limb length as a percentage of the intact femur, 68% ± 15.9) and another group using a SP (N = 11; mean age ± standard deviation, 49.6 ± 16.0 years; mean residual limb length as a percentage of the intact femur, 81% ± 13.9), and completed the 10-meter walk test, component timed-up-and-go, Prosthetic Limb Users Survey of Mobility™ 12-item, and Activities-specific Balance Confidence Scale.Results:There were no statistically significant differences between the BAP and SP groups in temporal spatial gait parameters and prosthetic mobility as measured by the 10-meter walk test and component timed-up-and-go, yet large effect sizes were found for several variables. In addition, Activities-specific Balance Confidence Scale and Prosthetic Limb Users Survey of Mobility™ scores were not statistically different between the BAP and SP groups, yet a large effect sizes were found for both variables.Conclusions:This study found that people with TFA who use a BAP can demonstrate similar temporal spatial gait parameters and prosthetic mobility, as well as self-perceived balance confidence and prosthetic mobility as SP users. Therefore, suggesting that the osseointegration reconstruction surgical procedure provides an alternative option for a specific population with TFA who cannot wear nor have limitations with a SP. Future research with a larger sample and other performance-based outcome measures and PROMs of prosthetic mobility and balance would further determine the differences between the prosthetic options.

show abstract

Section: Discussionmentioning

confidence: 99%

Comparison of prosthetic mobility and balance in transfemoral amputees with bone-anchored prosthesis vs. socket prosthesis

Gailey

Kristal

Muderis

et al. 2022

Prosthetics &Amp; Orthotics International

Self Cite

View full text Add to dashboard Cite

show abstract

“…Indivíduos fisicamente ativos são favorecidos, pois podem atingir a independência e a autonomia com maior facilidade, facilitando a participação ativa na sociedade, assim como a qualidade de vida desse indivíduo. 6,28,29,30 Tais afirmações ressaltam a importância da atividade física para esta população, assim como as positivas relações encontradas no presente estudo, com relação ao ajuste à prótese e a qualidade de vida.…”

Section: Discussionunclassified

“…As dificuldades psicológicas estão relacionadas principalmente às alterações psicossociais provenientes das dificuldades de ajuste à prótese, reinserção ocupacional, rede de apoio e transtornos de imagem e função corporal, que afetam a qualidade de vida e aumentam as chances de inatividade física. 1,2,3 As dificuldades físicas estão associadas aos déficits no equilíbrio e na força muscular, 4,5 na estabilidade corporal, no controle de tronco e nos ajustes de passadas durante a marcha, 6 que têm relação direta com a capacidade de deambulação e influenciam na diminuição do nível de atividade física e, consequentemente, dos seus benefícios. 7,8 As amputações de MMII provocam alterações no gasto energético (GE), isto é, indivíduos com esta condição podem apresentar aumento do GE durante a deambulação de aproximadamente 20% da demanda no consumo de oxigênio quando comparados a indivíduos sem amputações.…”

Section: Introductionunclassified

“…Os participantes do estudo apresentaram maiores pontuações no escore Lazer (12,50 MET h/d) e obtiveram gasto energético de 26,93 MET h/d e maiores médias de condições de Saúde Relacionado à Qualidade de Vida no domínio saúde mental (61,62). Ainda, os participantes do estudo apresentaram maiores médias relacionados ao Ajuste à Prótese no domínio Social (3,56) com Grau de Ajuste acima da média(6,42). É importante destacar que o valor mais alto do escore de restrição e limitação indica maiores restrições na participação, mas não apresentaram diferença significativa, as demais características (Tabela 2).…”

unclassified

See 1 more Smart Citation

Atividade física, ajuste à prótese e condição de saúde de pessoas com amputação de membro inferior

Lima,

Castro,

Weber

et al. 2023

Acta Fisiátr.

View full text Add to dashboard Cite

Objetivo: Relacionar atividade física, características demográficas e clínicas, ajuste à prótese e condições de saúde relacionada à qualidade de vida de adultos com amputações de membro inferior. Método: Participaram do estudo 70 indivíduos com amputações de membro inferior de ambos os sexos. Os dados foram coletados por meio de ficha para caracterização dos participantes, do Physical Activity Scale for Individual with Physical Disabilities (PASIPD), da Trinity Amputation and Prosthesis Experience Scales–Revised (TAPES-R) e do Short Form Health Survey (SF-12). Os dados foram analisados por meio de estatística descritiva e inferencial visando correlações, comparações e associações. Foi adotado p menor ou igual a 0,05. Resultados: Os resultados demonstraram que os participantes tiveram gasto energético de 26,93 MET h/d e maiores médias de condições de Saúde Relacionado à Qualidade de Vida no domínio saúde mental, ainda apresentaram maiores médias relacionados ao Ajuste à Prótese no domínio Social (3,56) com Grau de Ajuste acima da média (6,42). Conclusão: Os participantes do estudo apresentaram bom nível de atividade física, bom ajuste à prótese, boa saúde física e mental, melhor adaptação à amputação e participação. Além disso, também foi observado uma pior relação na adaptação entre pessoas com amputação acima do joelho, quando comparadas às amputações abaixo do joelho.

show abstract

“…The timing of intervention and prescription of exercises for subacute vs. chronic phases of recovery is a key consideration for precise evidence-based medicine tailored to the individual and optimizing functional outcomes. 13,14 In addition, an in-depth summary of exercise program characteristics including intensity, setting, equipment, exercise progression, and program adherence has not been completed. An understanding of these elements is fundamental to effective exercise program design.…”

Section: Introductionmentioning

confidence: 99%

The effect of exercise interventions on gait outcomes in subacute and chronic rehabilitation from lower-limb amputation: A systematic review and meta-analysis

Madou,

Sureshkumar,

Payne

et al. 2023

Prosthetics &Amp; Orthotics International

View full text Add to dashboard Cite

Successful walking is a substantial contributor to quality of life in people with lower-limb amputation (PLLA), yet gait difficulties are common. Evidence-based exercise guidelines are necessary for PLLA with different clinical characteristics and at different phases of recovery. To systematically review the literature evaluating effects of exercise interventions on gait outcomes in PLLA at subacute and chronic stages of recovery. Databases MEDLINE, EMBASE, CINAHL, SPORTDiscus, Scopus, and the Cochrane Library were searched (inception to May 10, 2022). Inclusion criteria: randomized controlled trials assessing gait outcomes following exercise intervention; subjects were PLLA ≥18 years of age and used a prosthesis for walking. Meta-analysis using random effects with inverse variance to generate standardized mean differences (SMDs) was completed for primary gait outcomes. Subgroup analysis was conducted for the recovery phase (i.e., subacute and chronic) and level of amputation (e.g., transfemoral and transtibial). Of 16 included articles, 4 studies examined the subacute phase of recovery, whereas 12 examined the chronic phase. Subacute interventions were 30 minutes, 1–7 times/week, for 2–12 weeks. Chronic interventions were 15–60-minutes, 2–3 times/week, for 4–16 weeks. Low–moderate level evidence was shown for a small improvement in the subacute phase (SMD = 0.42, 95% confidence interval [0.06–0.79], I2 = 46.0%) and a moderate improvement in the chronic phase (SMD = 0.67, 95% confidence interval [0.40–0.94], I2 = 0.0%) in favor of exercise intervention groups. Multicomponent exercise programs consisting of gait, balance, and strength training are effective at improving gait outcomes in PLLA at subacute and chronic phases of recovery. The optimal duration and frequency of exercise is unclear because of variation between interventions, highlighting an area for future work.

show abstract

Evidence-Based Amputee Rehabilitation: a Systematic Approach to the Restoration of Function in People with Lower Limb Loss

Cited by 6 publications

References 62 publications

Comparison of prosthetic mobility and balance in transfemoral amputees with bone-anchored prosthesis vs. socket prosthesis

Comparison of prosthetic mobility and balance in transfemoral amputees with bone-anchored prosthesis vs. socket prosthesis

Atividade física, ajuste à prótese e condição de saúde de pessoas com amputação de membro inferior

The effect of exercise interventions on gait outcomes in subacute and chronic rehabilitation from lower-limb amputation: A systematic review and meta-analysis

Contact Info

Product

Resources

About