Rehabilitation and the long-term outcomes of persons with trauma-related amputations

Pezzin, Liliana E.; Dillingham, Timothy R.; MacKenzie, Ellen J.

doi:10.1053/apmr.2000.0810292

Cited by 83 publications

(131 citation statements)

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“…We believe that these differences stem from the fact that the majority of the subjects in the unilateral group are much more active and motivated in their lives when compared with the bilateral amputee subjects. Herewith, as previous reports mention only worse SF-36 scores of amputee (vs. normal) subjects in general 12,13,16 ; our results (being even worse in bilateral amputees) would be noteworthy as well. Further, as QoL scores positively correlated with prosthetic use of the subjects (being more frequent in the unilateral group), we believe that prosthetics may have also contributed to the difference between the QoL scores of the two groups (being higher in the unilateral group).…”

Section: Discussionsupporting

confidence: 74%

Quality of life and functionality after lower limb amputations

Akarsu¹,

Tekin²,

Safaz

et al. 2013

Prosthetics &Amp; Orthotics International

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Background: It is difficult for the lower limb amputee patients to adapt to their new lifestyles. Objective: To compare the life quality and functionality of patients with bilateral vs. unilateral lower extremity amputations. Study Design: Cross-sectional study. Methods: Fifteen bilateral and 15 unilateral lower extremity amputee patients were enrolled. Demographics, cause and level of amputations, frequency and duration of prosthesis use were evaluated. SF-36, Satisfaction with Prosthesis Questionnaire (SAT-PRO), Amputee Body Image Scale. (ABIS), Houghton Scale (HS), six-minute walk test (6MWT), and 10-metre walk test (10 MWT) were performed. Results: Physical function, physical and emotional role scores of SF-36 were significantly lower in the bilateral amputee group in comparison with the unilateral group. SAT-PRO and ABIS total scores were similar between the groups. There was a positive correlation between the frequency of prosthetic use and SF-36 subgroups (except pain). The unilateral amputee group had significantly better scores than the bilateral amputee group in terms of HS, 6MWT and 10 MWT. Conclusion: Physical capacity of bilateral lower extremity amputee patients is lower than the unilateral amputee patients; satisfaction with prosthesis and body image are not related with the amputation level; and the life quality and satisfaction with prostheses are increased in parallel with the use of the prostheses. Clinical relevanceAlthough differences exist between the groups, in terms of quality of life and functionality, patients can reach an acceptable life standard with good rehabilitation and a suitable prosthesis.

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Section: Discussionsupporting

confidence: 74%

Quality of life and functionality after lower limb amputations

Akarsu¹,

Tekin²,

Safaz

et al. 2013

Prosthetics &Amp; Orthotics International

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“…Previous research has also supported the suggestion that psychosocial adaptation to amputation occurs over time (e.g. Livneh et al, 1999;Pezzin et al, 2000). In addition, age was significantly and negatively associated with adjustment to limitation, hence, younger age was associated with less favourable adjustment to limitation.…”

Section: Discussionmentioning

confidence: 60%

“…However, there is considerable variation in the psychosocial functioning of individuals with amputations. Many individuals function well, but a notable subgroup experience clinically significant psychological or social problems (Cansever, 2003;Dougherty, 2001;Hagberg & Branemark, 2001;Kashani, Frank, Kashani, Wonderlich, & Reid, 1983;Pezzin, Dillingham, & MacKenzie, 2000;Rybarczyk, Nyenhuis, Nicholas, Cash, & Kaiser, 1995).…”

Section: Introductionmentioning

confidence: 99%

Coping strategies as predictors of psychosocial adaptation in a sample of elderly veterans with acquired lower limb amputations

Desmond

MacLachlan

2006

Social Science & Medicine

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This study examines the contribution of demographic/amputation-related variables and coping strategies to the prediction of psychosocial adaptation in veterans with acquired lower limb amputations. Multiple indicators of the psychosocial adjustment of 796 individuals in the UK aged between 26-92 years with lower limb amputations were assessed. Hierarchical linear regressions were performed to investigate relationships between demographic/amputationrelated variables (i.e. age, time since amputation, amputation level and amputation aetiology), the dimensions of coping (namely problem solving, seeking social support and avoidance) and self-reported adaptation to amputation, as well as symptoms of intrusion, anxiety and depression. Results indicated that coping styles were important predictors of psychosocial adaptation. Avoidance was strongly associated with psychological distress and poor adjustment. In contrast, problem solving was negatively associated with depressive and anxious symptomatology whereas seeking social support was negatively associated with symptoms of depression and positively associated with social adaptation. These findings suggest the potential for interventions designed to promote particular coping strategies to improve psychosocial outcomes. r

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“…2 Although there is little evidence to date, it is logical to assume that similar benefits would be seen in patients who undergo amputations due to nontraumatic etiologies as well. As Dillingham et al 3,4 noted in 2 separate studies, few patients are referred to rehabilitation programs, however, with only 9.6% to 16% of patients discharged from acute services to inpatient rehabilitation after dysvascular amputation of a lower limb.…”

mentioning

confidence: 99%

“…Based on the Amputation Taxonomy of Care, our study distinguishes among 3 treatment process groups within the rehabilitation continuum: (1) veterans who have no evidence of a rehabilitation assessment while hospitalized, (2) veterans who have evidence of generalized rehabilitation through consultation level services only while hospitalized, and (3) veterans who have evidence of specialized rehabilitation through SRU admission after their amputation surgery. The treatment process is tracked by the entrance into the rehabilitation continuum.…”

mentioning

confidence: 99%

Does the Presence of a Specialized Rehabilitation Unit in a Veterans Affairs Facility Impact Referral for Rehabilitative Care After a Lower-Extremity Amputation?

Bates

Kurichi

Marshall³

et al. 2007

Archives of Physical Medicine and Rehabilitation

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Objective-To determine if the presence of specialized rehabilitation units (SRUs) within Veterans Affairs medical centers (VAMC) influences access to rehabilitation services. Design-Retrospective cohort analysis.Setting-Two types of VAMCs: those with and without SRUs. October 1, 2002, and September 30, 2003. There were a total of 2375 veterans with amputations: 99% were men; and 60% had transtibial, 40% had transfemoral, and less than 1% had hip disarticulation amputations. Nine hundred sixty-six patients (41%) were seen at a VAMC with an SRU. Participants-Veterans with lower-extremity amputations discharged from VAMCs between Interventions-Not applicable.Main Outcome Measure-Level of service provided expressed as: no evidence of rehabilitation during the hospitalization, generalized rehabilitation through consultation only, or admission to an SRU.Results-There were no differences between patients treated at facilities with SRUs and those treated in a facility without SRU beds with respect to age, sex, marital status, source of hospital admission, or level of amputation (all P<.05). Patients with lower initial FIM instrument scores were more likely to be treated in facilities with SRUs, and to have longer lengths of acute hospitalization (P<.01). Patients at facilities with an SRU compared with those without an SRU Reprints are not available from the author.No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated. NIH Public Access NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript had comparable likelihoods of being seen for an initial rehabilitation consultation (75% vs 74%, P=.56), but were more likely to be admitted for high intensity specialty rehabilitation services (26% vs 11%, P<.01).Conclusions-Although the majority of patients were seen in consultation, structural differences in service availability among clinically similar populations appear to be causing access disparities to specialized rehabilitation among amputees in the VAMC setting. The implication of these differences with regard to patient outcomes will need to be determined. KeywordsAmputation; Leg; Rehabilitation; Veterans Amputation of the lower limb can result in permanent impairment and disability, reducing the capacity for productive activities among people of all ages, but especially in the elderly. Lower-limb amputations in the United States can be expected to double from 28,000 to 58,000 per year by 2030 because of the disproportionate shifts in the oldest segments of our population, 1 making cost-effective rehabilitation strategies to help elderly patients achieve independence and home discharge increasingly essential in the upcoming decades.Rehabilitation immediately after the onset of any new impairment (including lowerextremity amputation) can be provided in a variety of ways that could be considered a continuum ranging from no rehab...

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Rehabilitation and the long-term outcomes of persons with trauma-related amputations

Cited by 83 publications

References 0 publications

Quality of life and functionality after lower limb amputations

Quality of life and functionality after lower limb amputations

Coping strategies as predictors of psychosocial adaptation in a sample of elderly veterans with acquired lower limb amputations

Does the Presence of a Specialized Rehabilitation Unit in a Veterans Affairs Facility Impact Referral for Rehabilitative Care After a Lower-Extremity Amputation?

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