General estimates of the energy cost of walking in people with different levels and causes of lower-limb amputation

The aim of the present study was to find out if it is possible to use the same functional tests for elderly subjects after lower limb amputation who live independently at their homes as for healthy ones. Will these tests discriminate among different problems in subjects with different levels and different causes of amputation and will they discriminate between active and sedentary subjects?The study examined 83 volunteers who lived independently at their homes (55 healthy sedentary, 17 after trans-tibial amputation, 11 after trans-femoral amputation). All subjects were aged 60 or older.All subjects after lower limb amputation were found to have significantly worse results in almost all tests in comparison with the healthy sedentary men. The subjects after trans-femoral amputation needed significantly more time at the “up and go” test, walked a shorter distance in 9 minutes, and performed fewer stand-ups from a chair and fewer steps in two minutes than the subjects after trans-tibial amputation. The active subjects after lower limb amputation had better balance, were quicker at the “up and go” test and walked longer in a minute than the sedentary subjects after lower limb amputation.It can be concluded that this test battery can also be used to test subjects after lower limb amputation because it discriminates among different severity of problems in subjects with different level and cause of amputation as well as between active and sedentary ones.

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Incidence of lower limb amputation in Australian hospitals from 2000 to 2010

Prosthetics and Orthotics International ◽

10.1177/0309364613490441 ◽

2013 ◽

Vol 38 (2) ◽

pp. 122-132 ◽

Cited By ~ 28

Author(s):

Michael P Dillon ◽

Friedbert Kohler ◽

Victoria Peeva

Keyword(s):

Lower Limb ◽

Clinical Relevance ◽

Contemporary Literature ◽

Lower Limb Amputation ◽

Limb Amputation ◽

National Hospital ◽

Hospital Morbidity ◽

Partial Foot Amputation ◽

Different Levels ◽

Over Time

Background: Contemporary literature reports that the incidence of lower limb amputation has declined in many countries. This impression may be misleading given that many publications only describe the incidence of lower limb amputations above the ankle and fail to include lower limb amputations below the ankle. Objectives: To describe trends in the incidence of different levels of lower limb amputation in Australian hospitals over a 10-year period. Study design: Descriptive. Method: Data describing the age-standardised incidence of lower limb amputation were calculated from the Australian National Hospital Morbidity database and analysed for trends over a 10-year period. Results: The age-standardised incidence of lower limb amputation remained unchanged over time ( p = 0.786). A significant increase in the incidence of partial foot amputations ( p = 0.001) and a decline in the incidence of transfemoral ( p = 0.00) and transtibial amputations ( p = 0.00) were observed. There are now three lower limb amputations below the ankle for every lower limb amputation above the ankle. Conclusion: While the age-standardised incidence of all lower limb amputation has not changed, a shift in the proportion of lower limb amputations above the ankle and lower limb amputations below the ankle may be the result of improved management of precursor disease that makes partial foot amputation a more commonly utilised alternative to lower limb amputations above the ankle. Clinical relevance This article highlights that although the incidence of lower limb amputation has remained steady, the proportion of amputations above the ankle and below the ankle has changed dramatically over the last decade. This has implications for how we judge the success of efforts to reduce the incidence of lower limb amputation and the services required to meet the increasing proportion of persons with amputation below the ankle.

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