Daily functioning of the lower extremity amputee: an overview of the literature

The aim of this paper is to review the existing literature on the incidence, morbidity and mortality of lower limb amputation. The functional level of the lower limb amputee and the predictive factors for functioning with a prosthesis are reviewed, both for unilateral and for bilateral amputees. The reported incidence of lower extremity amputation (LEA) varies considerably between different Western countries. The mean survival of LEA patients ranges between two and five years. Assessment of functional outcome is carried out differently. Studies are not comparable and most concern selected groups of amputees. Increasing age, concurrent disease and poor compliance are prognostic factors for a low functional level. For optimal planning of rehabilitation it is necessary to study a complete cohort of amputees with respect to these prognostic factors.

[1]  A. Delitto,et al.  Selective criteria for successful long-term prosthetic use. , 1985, Physical therapy.

[2]  K. M. Chan,et al.  Use of lower limb prosthesis among elderly amputees. , 1990, Annals of the Academy of Medicine, Singapore.

[3]  L. Ebskov.  Epidemiology of lower limb amputations in diabetics in Denmark (1980 to 1989) , 2004, International Orthopaedics.

[4]  P. Morris,et al.  Amputation for vascular disease: The experience of a peripheral vascular unit , 1980, The British journal of surgery.

[5]  A. Kald,et al.  Major amputation in a defined population: Incidence, mortality and results of treatment , 1989, The British journal of surgery.

[6]  C. Beekman,et al.  Prosthetic use in elderly patients with dysvascular above-knee and through-knee amputations. , 1987, Physical therapy.

[7]  G R Fernie,et al.  Extent of artificial limb use following rehabilitation , 1987, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[8]  B. Persson,et al.  Increased incidence of lower limb amputation for arterial occlusive disease. , 1983, Acta orthopaedica Scandinavica.

[9]  L. Ebskov.  Level of lower limb amputation in relation to etiology: An epidemiological study , 1992, Prosthetics and orthotics international.

[10]  M. Krasnik,et al.  Wound healing complications following major amputations of the lower limb , 1982, Prosthetics and orthotics international.

[11]  Rehabilitation of below-knee amputees: factors influencing outcome and costs in three programmes. , 1989, International disability studies.

[12]  H. Alaranta,et al.  Primary survival and prosthetic fitting of lower limb amputees , 1989, Prosthetics and orthotics international.

[13]  E. Burgess,et al.  Amputations of the leg for peripheral vascular insufficiency. , 1971, The Journal of bone and joint surgery. American volume.

[14]  T. O'donnell,et al.  Below-knee amputation: is the effort to preserve the knee joint justified? , 1980, Archives of surgery.

[15]  J. A. Schwartz,et al.  Lower extremity amputation: the control series. , 1986, Journal of vascular surgery.

[16]  P Sinnock,et al.  The Epidemiology of Lower Extremity Amputations in Diabetic Individuals , 1983, Diabetes Care.

[17]  Cause of death of lower limb amputees , 1992, Prosthetics and orthotics international.

[18]  N. D. Luccia,et al.  Rehabilitation after amputation for vascular disease: A follow-up study , 1992, Prosthetics and orthotics international.

[19]  B. Persson,et al.  Amputation for occlusive arterial disease. A prospective multicentre study of 177 amputees. , 1992, International orthopaedics.

[20]  H. Day,et al.  The assessment and description of amputee activity , 1981, Prosthetics and orthotics international.

[21]  L. Niskanen,et al.  Lower-Extremity Amputations in Diabetic and Nondiabetic Patients: A population-based study in eastern Finland , 1993, Diabetes Care.

[22]  P. Stern.  Occlusive Vascular Disease of Lower Limbs: Diagnosis, Amputation Surgery and Rehabilitation: A Review of the Burke Experience , 1988, American journal of physical medicine & rehabilitation.

[23]  S. Ogston,et al.  Lower limb amputee survival , 1992, Prosthetics and orthotics international.

[24]  S. Marshall,et al.  A functional and social review of lower‐limb amputees , 1973, The British journal of surgery.

[25]  C. Gauthier-Gagnon,et al.  Prosthetic profile of people with lower extremity amputation: conception and design of a follow-up questionnaire. , 1993, Archives of physical medicine and rehabilitation.

[26]  L. Jones.  Lower limb amputation in three Australian states. , 1990, International disability studies.

[27]  F. Lithner,et al.  Amputations in diabetic patients in Gotland and Umeå counties 1971-1980. , 2009, Acta medica Scandinavica. Supplementum.

[28]  W. Evans,et al.  Rehabilitation of the bilateral amputee. , 1987, Journal of vascular surgery.

[29]  L. Jones,et al.  Ability or disability? A study of the functional outcome of 65 consecutive lower limb amputees treated at the Royal South Sydney Hospital in 1988-1989. , 1993, Disability and rehabilitation.

[30]  P. Bertrand,et al.  Factors influencing rehabilitation of arteriosclerotic lower limb amputees. , 1991, Journal of rehabilitation research and development.

[31]  H. Alaranta,et al.  Predictive factors of functional ability after lower-limb amputation. , 1991, Annales chirurgiae et gynaecologiae.

[32]  H. Alaranta,et al.  Prosthetic use and functional and social outcome following major lower limb amputation , 1990, Prosthetics and orthotics international.

[33]  Eickhoff Jh.  Changes in the number of lower limb amputations during a period of increasing vascular surgical activity. Results of a nation-wide study, Denmark, 1977-1990 , 1993 .

[34]  G. Jones,et al.  Bilateral below-knee amputations: experience with 80 patients. , 1986, Archives of physical medicine and rehabilitation.

[35]  Use of lower limb prosthesis among elderly amputees. , 1990 .

[36]  E M Burgess,et al.  Contralateral limb and patient survival after leg amputation. , 1983, American journal of surgery.

[37]  R. Goldberg,et al.  Functional changes in vascular amputee patients: evaluation by Barthel Index, PULSES profile and ESCROW scale. , 1985, Archives of physical medicine and rehabilitation.

[38]  F. Hutchinson,et al.  Prosthetic usage following major lower extremity amputation. , 1989, Clinical orthopaedics and related research.

[39]  J. Falkel.  Amputation as a Consequence of Diabetes Mellitus , 1983 .

[40]  F. Steinberg,et al.  Prosthetic rehabilitation of geriatric amputee patients: a follow-up study. , 1985, Archives of physical medicine and rehabilitation.

[41]  E. Miller,et al.  Diabetes-related lower extremity amputations in New Jersey, 1979 to 1981. , 1985, The Journal of the Medical Society of New Jersey.

[42]  V. Kristiansen,et al.  Function after lower limb amputation. , 1986, Acta orthopaedica Scandinavica.

[43]  J. D. Morrison,et al.  Changing pattern of lower limb amputation for vascular disease , 1986, The British journal of surgery.

[44]  N. Couch,et al.  Natural history of the leg amputee. , 1977, American Journal of Surgery.

[45]  D. Wade,et al.  Functional outcome of lower limb amputees with peripheral vascular disease , 1992 .

[46]  D. Datta,et al.  Outcome of prosthetic management of bilateral lower-limb amputees. , 1992, Disability and rehabilitation.

[47]  Use and usefulness of lower limb prostheses , 1988, International journal of rehabilitation research. Internationale Zeitschrift fur Rehabilitationsforschung. Revue internationale de recherches de readaptation.

[48]  B. Ebskov,et al.  Incidence of reamputation and death after gangrene of the lower extremity , 1980, Prosthetics and orthotics international.

[49]  A. Jain,et al.  Dundee revisited — 25 years of a total amputee service , 1993, Prosthetics and orthotics international.

[50]  H L Thornhill,et al.  Long-term function of persons with atherosclerotic bilateral below-knee amputation living in the inner city. , 1990, Archives of physical medicine and rehabilitation.

[51]  D. Bild,et al.  Lower-Extremity Amputation in People With Diabetes: Epidemiology and Prevention , 1989, Diabetes Care.

[52]  R. Waters,et al.  Energy cost of walking of amputees: the influence of level of amputation. , 1976, The Journal of bone and joint surgery. American volume.

[53]  J. Marcus,et al.  Prosthetic rehabilitation of elderly bilateral amputees , 1989, International journal of rehabilitation research. Internationale Zeitschrift fur Rehabilitationsforschung. Revue internationale de recherches de readaptation.

[54]  E M Burgess,et al.  Functional capabilities of lower extremity amputees. , 1978, Archives of physical medicine and rehabilitation.

[55]  W. Newman,et al.  Factors influencing reintegration to normal living after amputation. , 1992, Archives of physical medicine and rehabilitation.

[56]  C. C. Nielsen,et al.  A Survey of Amputees: Functional Level and Life Satisfaction, Information Needs, and the Prosthetist??s Role , 1991 .

[57]  F. W. Wagner,et al.  Ambulation levels of bilateral lower-extremity amputees. Analysis of one hundred and three cases. , 1983, The Journal of bone and joint surgery. American volume.

[58]  H. Ringertz,et al.  Amputations for vascular insufficiency , 1983, Prosthetics and orthotics international.

[59]  L. Ebskov.  Lower limb amputations for vascular insufficiency , 1991, International journal of rehabilitation research. Internationale Zeitschrift fur Rehabilitationsforschung. Revue internationale de recherches de readaptation.

[60]  H. Alaranta,et al.  Lower limb amputations in Southern Finland 1984-1985 , 1988, Prosthetics and orthotics international.

[61]  C. B. Ernst,et al.  Morbid implications of above-knee amputations. Report of a series and review of the literature. , 1980, Archives of surgery.

[62]  D. Dwyer,et al.  Functional screening of lower-limb amputees: a role in predicting rehabilitation outcome? , 1992, Archives of physical medicine and rehabilitation.

[63]  L. Vos,et al.  Functional outcome of rehabilitated bilateral lower limb amputees , 1994, Prosthetics and orthotics international.

[64]  I. Narang,et al.  Functional capabilities of lower limb amputees , 1984, Prosthetics and orthotics international.

[65]  B. Persson,et al.  Amputation for occusive arterial disease , 2004, International Orthopaedics.