Factors Affecting Prosthetic Rehabilitation Outcomes in Amputees of Age 60 Years and Over

Hamamura, Sayaka; Chin, Takaaki; Kuroda, Ryosuke; Akisue, Toshihiro; Iguchi, Tetsuhiro; Kohno, H; Kitagawa, A.; Tsumura, Nobuhiro; Kurosaka, Masahiro

doi:10.1177/147323000903700630

Cited by 40 publications

(50 citation statements)

References 15 publications

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“…Hamamura et al, in a high quality study, found significance in motivation as a predictive factor for successful prosthetic ambulation among geriatric subjects (17). This is consistent with a previous report finding a statistically significant association between patient “motivation” and the ability to learn to walk with a prosthesis (5).…”

Section: Discussionmentioning

confidence: 99%

“…Hamamura et al, in a high quality study, identified the patient’s ability to stand on one leg on the non-amputated limb as one of the most valuable factors contributing to successful prosthetic ambulation in geriatric amputees, reporting significance in successful prosthetic walkers (17). van Eijk et al, in a medium quality article, reported that one-leg balance was significantly positively associated with prosthetic use (20).…”

Section: Discussionmentioning

confidence: 99%

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Predicting Walking Ability Following Lower Limb Amputation: An Updated Systematic Literature Review

Highsmith²,

et al. 2016

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There is not a clear clinical recommendation for the determination of prosthetic candidacy. Guidelines do not delineate which member(s) of the multidisciplinary team are responsible for prosthetic candidacy decisions and which factors will best predict a positive outcome. Also not clearly addressed is a patient-centered decision-making role. In a previous systematic review (SR), Sansam et al. reported on the prediction of walking ability following lower limb amputation using literature up to 2007. The search strategy was designed from the previous Sansam SR as an update of previously valuable predictive factors of prosthetic candidacy. An electronic literature search was executed from August 8, 2007, to December 31, 2015, using MEDLINE (Pubmed), Embase, The Cumulative Index to Nursing and Allied Health Literature (CINAHL) (Ovid), and Cochrane. A total of 319 studies were identified through the electronic search. Of these, 298 were eliminated, leaving a total of 21 for full evaluation. Conclusions from this updated study are drawn from a total recruited sample (n) of 15,207 subjects. A total of 12,410 subjects completed the respective studies (18% attrition). This updated study increases the size of the original Sansam et al. report by including 137% more subjects for a total of 21,490 between the two articles Etiology, physical fitness, pre-amputation living status, amputation level, age, physical fitness, and comorbidities are included as moderate to strongly supported predictive factors of prosthetic candidacy. These factors are supported in an earlier literature review and should be strongly considered in a complete history and physical examination by a multidisciplinary team. Predictive factors should be part of the patient’s healthcare record.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Predicting Walking Ability Following Lower Limb Amputation: An Updated Systematic Literature Review

Highsmith²,

et al. 2016

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“…Previous literature suggests age [44–48], comorbidities [44,46] and indication for amputation [46] to be factors potentially limiting amputees to perform functionally in the community. Differences in age were found between the K1/2 and K4 amputees.…”

Section: Discussionmentioning

confidence: 99%

Use of an Activity Monitor and GPS Device to Assess Community Activity and Participation in Transtibial Amputees

Hordacre

Barr

Crotty

2014

Sensors

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This study characterized measures of community activity and participation of transtibial amputees based on combined data from separate accelerometer and GPS devices. The relationship between community activity and participation and standard clinical measures was assessed. Forty-seven participants were recruited (78% male, mean age 60.5 years). Participants wore the accelerometer and GPS devices for seven consecutive days. Data were linked to assess community activity (community based step counts) and community participation (number of community visits). Community activity and participation were compared across amputee K-level groups. Forty-six participants completed the study. On average each participant completed 16,645 (standard deviation (SD) 13,274) community steps and 16 (SD 10.9) community visits over seven days. There were differences between K-level groups for measures of community activity (F(2,45) = 9.4, p < 0.001) and participation (F(2,45) = 6.9, p = 0.002) with lower functioning K1/2 amputees demonstrating lower levels of community activity and participation than K3 and K4 amputees. There was no significant difference between K3 and K4 for community activity (p = 0.28) or participation (p = 0.43). This study demonstrated methodology to link accelerometer and GPS data to assess community activity and participation in a group of transtibial amputees. Differences in K-levels do not appear to accurately reflect actual community activity or participation in higher functioning transtibial amputees.

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“…The psychological willingness to use the prosthesis, expressed as the motivation to walk, was found to be significantly different between older individuals who successfully functioned with their prosthesis and those who were unsuccessful [15]. Miller et al also found that balance confidence, measured by the Activities-Specific Balance Confidence scale (ABC), played a significant role in predicting prosthetic use, mobility, and participation in community and social activities [16].…”

Section: Introductionmentioning

confidence: 97%

“…Prosthetic functioning requires an individual to have both sufficient physical performance ability and the motivation and confidence to try to use the prosthesis in different ways in the course of life's activities [15]. The psychological willingness to use the prosthesis, expressed as the motivation to walk, was found to be significantly different between older individuals who successfully functioned with their prosthesis and those who were unsuccessful [15].…”

Section: Introductionmentioning

confidence: 99%

Role of balance ability and confidence in prosthetic use for mobility of people with lower-limb loss

et al. 2014

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Abstract-For people with lower-limb loss, impaired balance is common and limits prosthetic function within the community. This cross-sectional study (1) analyzed relationships among prosthetic use for mobility, balance ability and confidence, and amputation-related variables and (2) determined multivariate models to identify level of prosthetic use. Subjects included 46 community-dwelling adults (mean age 56.2 yr) with limb loss (91.3% unilateral) of varied levels (52.2% transtibial) and etiologies (69.6% vascular). A three-variable linear regression model including balance ability, balance confidence, and years since amputation explained 63.7% of variance in the Houghton scale of prosthetic use score. A logistic regression model including the 14-task Berg Balance Scale, balance confidence, years since amputation, age, and number of comorbidities correctly differentiated between people who had reached a satisfactory level of prosthetic use or not 89.1% of the time. The first three variables demonstrated moderate accuracy with positive likelihood ratios from 2.34 to 4.35. The regression model was further reduced to correctly classify 87.0% of cases with three balance ability tasks (retrieving objects from floor, turning to look behind, and placing alternate foot on stool), balance confidence, and numbers of comorbidities. Logistic models that include balance ability, balance confidence, and numbers of comorbidities can identify level of prosthetic use in people with lower-limb loss. Increased balance confidence and ability when retrieving objects from floor, turning to look behind, and placing alternate foot on stool were most indicative of successful prosthetic use for mobility.

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Factors Affecting Prosthetic Rehabilitation Outcomes in Amputees of Age 60 Years and Over

Cited by 40 publications

References 15 publications

Predicting Walking Ability Following Lower Limb Amputation: An Updated Systematic Literature Review

Predicting Walking Ability Following Lower Limb Amputation: An Updated Systematic Literature Review

Use of an Activity Monitor and GPS Device to Assess Community Activity and Participation in Transtibial Amputees

Role of balance ability and confidence in prosthetic use for mobility of people with lower-limb loss

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