ArticlesInterruptions to amputee rehabilitation☆,☆☆
Section snippets
Study design
A retrospective cohort design was used. Ethics approval was obtained before initiation of the study from the Research Ethics Committee at our institution.
Setting
All data were collected from an inpatient amputee rehabilitation unit located in a tertiary rehabilitation center. The unit's mandate is to accept patients from acute care hospitals as early as possible after amputation surgery and to provide all necessary amputee rehabilitation services including prosthetic fitting and multidisciplinary
Sample characteristics
Baseline demographic data for the 254 study participants are in table 1.Sex, n (%) Male 182 (72%) Female 72 (28%) Mean age (y) 66.0±2.7 Amputation type, n (%) Below knee 152 (60%) Above knee 44 (17%) Bilateral 51 (20%) Other 7 (3%) Mean days from amputation to admission 15.6±10.9 Mean admission SF-36 score (n=190) Physical composite score 25.8±7.1 Mental composite score 42.5±12.3 Mean no. of comorbid medical conditions 2.8±1.4 Comorbid medical conditions, n (%) Peripheral vascular disease
Discussion
This review of 254 consecutive inpatient amputee rehabilitation patients shows that interruptions to amputee rehabilitation are very common, occurring in almost one third (29.9%). In this series, the most common causes of interruption were delayed wound healing (13%), acute medical illness (10.2%), and amputation revision surgery (5.1%). In total, 15.4% (39/254) of the patients required transfer from rehabilitation to acute care hospital because they had acute medical problems or needed
Conclusions
Interruptions to inpatient amputee rehabilitation were very common (30%), and many required transfer to acute hospital (15%), an incidence which appears similar to that reported in the general rehabilitation population. The most common causes for interruption were impaired stump healing (18%) and acute medical illness (10%). All patients were at high risk for interruption, with the only identified risk factors being female gender, fewer days from amputation to rehabilitation admission, and the
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Quantifying the risk of falls and injuries for amputees beyond annual fall rates—A longitudinal cohort analysis based on person-step exposure over time
2021, Preventive Medicine ReportsCitation Excerpt :PLL with limited walking ability may have elevated injury risk due to chronic vascular conditions that make skin more vulnerable (Wong et al., 2020). Consistent with the finding that PLL have episodes of delayed healing and recovery (Meikle et al., 2002), two participants had minor skin injuries that depressed their walking ability for weeks after a period of improvement. While incidence of fall-related injury in PLL is high (Wong et al., 2016), the study results suggest that not all falls are consequential and that residual limb injuries occur without falls.
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2021, European Journal of Vascular and Endovascular SurgeryCitation Excerpt :There were 64 studies reporting the use of PROMs in a population including patients who had undergone amputation as a result of diabetes and/or PAD. These studies included a total of 29 314 patients (range 1–11 130) across four continents (Tables 1 and 2).5,8,25–34,17,35–44,18,45–54,19,55–64,20,65–74,21,75,76,22–24 Most studies (n = 51, 80%) included patients with either diabetes or PAD, with nine (14%) including only patients with PAD and four (6%) including only those with diabetes.
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2020, Archives of Physical Medicine and RehabilitationCitation Excerpt :The Medical Outcome Short Form 36 version 2 (SF-36v2) is a generic HR-QoL measure that has been shown to be valid and reliable across a number of populations.15,16 Although the SF-36v2 has never been validated for a population with lower limb amputation, its sensitivity to changes and widespread use suggests its acceptance for use in this population.12,17-20 The SF-36v2 can be administered in an electronic format and has a low burden, taking approximately 10 minutes to complete.
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2020, Physiotherapy (United Kingdom)Citation Excerpt :The most consistent modifiable factor was concurrent comorbidities. Comorbidities, particularly skin breakdown, complicate and delay rehabilitation after limb loss [28]. Most samples were small; only 12 studies had samples larger than 300 [11,12].
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2013, Archives of Physical Medicine and RehabilitationClinical Identification of Multiple Fall Risk Early After Unilateral Transtibial Amputation
2007, Archives of Physical Medicine and RehabilitationCitation Excerpt :Previous amputee studies performed by using large samples (n range, 254−329) reported the same sex ratio, age, type, and number of comorbidities as our sample. With men forming 72% to 74% of the amputee population, age 59.9 to 66 years,18-20 and PVD or diabetes as the most common comorbidities,18,20 the number of comorbidities in our sample (2.57±1.54) was also similar to that previously reported (2.8±1.4).18 Functionally, our population was also similar to other study samples, with our total sample (n=47) having a TUG test of 19.73±11.11.
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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.
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Correspondence to Ben Meikle, MD, Ste R3-89, West Park Health Care Centre, 82 Buttonwood Ave, Toronto, Ont M6M 2J5, Canada. Reprints are not available.