Mobility outcome following unilateral lower limb amputation

This study investigated mobility outcome following unilateral trans-tibial or trans-femoral amputation. It was an observational study at the sub-regional amputee rehabilitation centre in Sheffield, UK. All unilateral trans-tibial or trans-femoral amputees referred during the study period were included. The Harold Wood Stanmore mobility grade was recorded approximately one year following initial assessment at the centre. Of the 357 amputees referred, complete outcome data was available for 281 (78.7%). The mean age was 68 years (range 16–95), 70.1% were male, and the aetiology of the amputation was vascular or diabetic in 87.5% of cases. Trans-tibial amputations accounted for 50.5% and trans-femoral 49.5%. Almost all trans-tibial and trans-femoral amputees aged 50 and under achieved functional household and community mobility. Approximately 50% of the trans-tibial amputees aged over 50 years gained independent community mobility and around 60% household mobility. There was a significant worsening of community mobility rates with increasing age but for household mobility the differences did not reach statistical significance. Fewer than 25% of trans-femoral amputees aged over 50 achieved community mobility and around 50% achieved household mobility. There was a statistically significant deterioration in both community and household mobility levels with increasing age. This study concludes that mobility rates one year after prosthetic provision for unilateral transtibial and trans-femoral amputees worsen with increasing age at amputation and a higher level of amputation.

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

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

[3]  R. Hanspal,et al.  Assessment of cognitive and psychomotor function and rehabilitation of elderly people with prostheses. , 1991, BMJ.

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

[5]  Fyfe Nc,et al.  Success rates for rehabilitation of vascular amputees: implications for preoperative assessment and amputation level. , 1993 .

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

[7]  J. Pell,et al.  Quality of life following lower limb amputation for peripheral arterial disease. , 1993, European journal of vascular surgery.

[8]  J. D. Morrison,et al.  Rehabilitation outcome 5 years after 100 lower‐limb amputations , 1994, The British journal of surgery.

[9]  D. Datta,et al.  Surgery for limb threatening ischaemia: a reappraisal of the costs and benefits. , 1995, European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery.

[10]  P. McCollum,et al.  Rehabilitation outcome 5 years after 100 lower limb amputations , 1995, The British journal of surgery.

[11]  J. Groothoff,et al.  Clinical rehabilitation of the amputee: A retrospective study , 1996, Prosthetics and orthotics international.

[12]  R. Hanspal,et al.  Prediction of achieved mobility in prosthetic rehabilitation of the elderly using cognitive and psychomotor assessment , 1997, International journal of rehabilitation research. Internationale Zeitschrift fur Rehabilitationsforschung. Revue internationale de recherches de readaptation.

[13]  L. Turner-Stokes,et al.  The use of standardized outcome measures in rehabilitation centres in the UK , 1997, Clinical rehabilitation.

[14]  H. Alaranta,et al.  Ten-year survival of Finnish lower limb amputees , 1998, Prosthetics and orthotics international.

[15]  W H Eisma,et al.  Mobility of people with lower limb amputations: scales and questionnaires: a review , 2001, Clinical rehabilitation.

[16]  A. Tennant,et al.  The SIGAM mobility grades: a new population-specific measure for lower limb amputees , 2003, Disability and rehabilitation.