Rehabilitation outcome of post-acute lower limb geriatric amputees

Hershkovitz, Avital; Dudkiewicz, Israel; Brill, Shai

doi:10.3109/09638288.2012.690818

Cited by 30 publications

(29 citation statements)

References 29 publications

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“…In the United States alone, the number of persons with bilateral transtibial amputation 1 has been estimated to be 11,400. 5,6 With advances in rehabilitation therapy and technology, independent ambulation can often be achieved, enabling patients to walk with little or no crutch support. Without a sound leg to provide balance, proprioception, and stability, prosthetic fitting and gait training are more problematic than in persons with unilateral amputation.…”

Section: Rehabilitation Of Persons With Bilateral Lower-limb Lossmentioning

confidence: 99%

Leg Laterality Differences in Persons with Bilateral Transtibial Amputation

Fiedler

Slavens

Hafner

et al. 2013

JPO Journal of Prosthetics and Orthotics

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Rehabilitation of persons with bilateral transtibial amputation is challenged by the unavailability of a sound leg to provide stability in standing and gait. Absence of a sound limb complicates both prosthetic fitting and gait training. Little evidence related to prosthetic fitting and gait training of persons with bilateral amputation is available to guide these clinical procedures. This work addresses questions that are frequently encountered by prosthetists, including is there a disparity in leg strength or controllability between limbs and, if so, which is the favored or dominant leg? A disparity or leg laterality may have implications in the selection and adjustment of prosthetic components, prescription of rehabilitation therapies, or recommendations for the use of assistive devices. In this study, the gait of two persons with bilateral transtibial amputation was assessed using prosthesis-integrated load cells installed in both legs. The load cells provided continuous measurement of kinetic and temporal outcomes (forces and moments) measured during gait on different surfaces and on stairs. Pairwise comparisons of gait variables measured by each load cell were used to quantify leg laterality. The results of this study suggest that integrated load cells have the potential to assess leg laterality in persons with bilateral amputation and that these may be useful tools for enhancing the clinical decision-making process. (J Prosthet Orthot. 2013;25:168Y176.)

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Section: Rehabilitation Of Persons With Bilateral Lower-limb Lossmentioning

confidence: 99%

Leg Laterality Differences in Persons with Bilateral Transtibial Amputation

Fiedler

Slavens

Hafner

et al. 2013

JPO Journal of Prosthetics and Orthotics

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“…10 Presence of CI is also associated with undesirable functional outcomes (e.g., poor mobility, decreased prosthesis use, and loss of independence) among people with LLL. 3, 11–14 As such, identifying and understanding cognitive issues in people with LLL may be critical to optimizing treatment and promoting long-term health outcomes. It is also important to know whether CI differentially affects people of different ages or LLL etiologies so as to inform which individuals may be candidates for cognitive assessment.…”

Section: Introductionmentioning

confidence: 99%

Self-Reported Cognitive Concerns in People With Lower Limb Loss

Morgan

Kelly

Amtmann

et al. 2016

Archives of Physical Medicine and Rehabilitation

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Objective To investigate differences between self-reported cognitive concerns in people with lower limb loss (LLL) and normative data derived from the U.S. general population. A secondary aim was to determine if there were cognitive differences based on amputation etiology or age. Design Survey. Setting General community. Participants A volunteer sample of 1086 persons with LLL resulting from trauma or dysvascular complications who regularly use a prosthetic limb. Interventions Not applicable. Main Outcome Measure The Quality of Life in Neurological Disorders Applied Cognition General Concerns v1.0 Short Form (Neuro-QoL ACGC), an eight-item self-report measure of general cognitive concerns. Results People with LLL reported significantly more cognitive concerns than the Neuro-Qol normative sample. Mean Neuro-QoL ACGC scores were significantly lower than normative values (p<0.001) across subgroups defined by age (i.e., <40, 40–49, 50–59, 60–69, and 70+ years) and subgroups defined by etiology (i.e., traumatic and dysvascular LLL). However, there were no significant differences in cognitive concerns among age subgroups (p=0.84) or between the etiology subgroups (p=0.58). Conclusions When compared to the Neuro-QoL normative sample, individuals with LLL report greater concerns with cognitive health. Cognitive concerns were not differentially affected by age or cause of amputation. The presence of cognitive concerns in people with LLL suggests a need to assess perceived cognitive function in order to tailor education and training in prosthetic use and care.

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“…[6][7][8][9] Moreover, the mortality rates are high; in several studies, more than one-third of the participants died during the first year after amputation. [10][11][12][13] Therefore, the promotion of autonomy and quality of life in this population group constitutes a major challenge for health policy.…”

Section: Introductionmentioning

confidence: 99%

“…However, little is known about the effects of rehabilitation interventions on independence in basic ADL. [12,[33][34][35][36] Moreover, in contrast to the large number of studies on factors associated with post-rehabilitation recovery of ambulation and prosthetic use, there is little evidence regarding the determinants of ADL outcomes after a rehabilitation program. [34,36] In people with lower-limb amputation, independence in self-care activities is significantly associated with higher rates of survival after six months of rehabilitation [37] and prosthetic use, [38] and predicts a good walking ability.…”

Section: Introductionmentioning

confidence: 99%

Activities of daily living in people with lower limb amputation: outcomes of an intervention to reduce dependence in pre-prosthetic phase

Celeiro

Sanjuán

Santos-del-Riego

2016

Disability and Rehabilitation

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A short and pre-prosthetic ADL intervention improves functional independence and reduces the need for home adaptation. ADL programs should be included in rehabilitation strategies. Implications for Rehabilitation Because basic activities of daily living (ADL) can be seriously compromised after a lower-limb amputation, it is important for this population to improve or maintain their level of independence. A short and pre-prosthetic ADL intervention is an effective method for an early recovery of functional independence in self-care activities and promotes home adaptation. Age is an important determinant of functional recovery, and most subjects can achieve independence in basic ADL regardless of the level of amputation. A pre-prosthetic ADL program should be included in rehabilitation strategies for adults with lower-limb amputation.

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Rehabilitation outcome of post-acute lower limb geriatric amputees

Abstract: Rehabilitation efforts should best be targeted depending on need. Rehabilitation professionals should make an educated estimate of outcomes at the beginning of rehabilitation based on the characteristics of the patients (level of amputation and functional level on admission).

Cited by 30 publications

References 29 publications

Leg Laterality Differences in Persons with Bilateral Transtibial Amputation

Leg Laterality Differences in Persons with Bilateral Transtibial Amputation

Self-Reported Cognitive Concerns in People With Lower Limb Loss

Activities of daily living in people with lower limb amputation: outcomes of an intervention to reduce dependence in pre-prosthetic phase

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