Patient satisfaction following lower-limb amputation: the role of gait deviation

2011 ◽  
Vol 35 (2) ◽  
pp. 225-233 ◽  
Author(s):  
Lauren Kark ◽  
Anne Simmons
Keyword(s):  
Patient Satisfaction ◽  
Lower Limb ◽  
Functional Ability ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Timed Up And Go ◽  
Cross Sectional ◽  
High Functioning ◽  
Satisfaction Measures

Background: Patient satisfaction is an important measurement in healthcare for administrators, clinicians and patients.Objectives: This study investigated the role of gait deviation in patient satisfaction following lower-limb amputation and prosthesis prescription.Study design: A cross-sectional study was done.Methods: Twenty community-based unilateral lower-limb amputees, 12 transtibial and 8 transfemoral, were recruited from support groups. Participants completed the prosthesis evaluation questionnaire (PEQ) with embedded satisfaction-related questions, the timed-up-and-go test and the six-minute walk test, and also underwent quantitative three-dimensional analysis. Kinematic deviation was summarized using the gait profile score (GPS).Results: Satisfaction levels were generally high (median 80 + /100). Sociodemographic variables did not correlate significantly with any of the satisfaction measures (−0.35 ≤  r ≤ 0.54). Satisfaction correlated strongly with the PEQ scales, particularly ambulation, prosthetic utility, frustration, perceived response and social burden ( r ≥ 0.70). By contrast, the relationships between satisfaction and performance-based outcome measures were not significant (−0.45 ≤  r ≤ 0.43), and the GPS did not correlate with any satisfaction measures (−0.23 ≤  r ≤ 0.15).Conclusions: In this study of high functioning amputees, gait deviation was unimportant to the amputee, while self-reported functional ability and attitudes toward the prosthesis were the strongest correlates of satisfaction following lower-limb amputation.Clinical relevance For the high functioning individuals with lower-limb amputation in this study, gait deviation was not a significant correlate of patient satisfaction. Results suggest that improving self-perceived functional ability and attitudes toward the prosthesis, rather than minimizing gait deviation, will improve patient satisfaction.

scholarly journals The Relationship Between Vestibular Sensory Integration and Prosthetic Mobility in Community Ambulators With Unilateral Lower Limb Amputation

2020 ◽  
Author(s):  
Jennifer Lučarević ◽  
Ignacio Gaunaurd ◽  
Sheila Clemens ◽  
Paulina Belsky ◽  
Lauren Summerton ◽  
...  
Keyword(s):  
Lower Limb ◽  
Sensory Integration ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Clinical Test ◽  
Timed Up And Go ◽  
Convenience Sample ◽  
The Relationship ◽  
Step Turn ◽  
Degree Step

Abstract Objective The modified Clinical Test of Sensory Interaction and Balance (mCTSIB) is used to clinically assess vestibular sensory integration (VSI), the process by which the central nervous system integrates vestibular afference to maintain balance. The rate and effects of impaired VSI (IVSI) on prosthetic mobility in people with lower limb amputation (LLA) is unknown. The objective of this study was to use the mCTSIB to classify VSI in active community ambulators with LLA and to examine the relationship between IVSI and prosthetic mobility, as measured by the Component Timed Up and Go (cTUG) test. Methods This was a cross-sectional study with a convenience sample of 130 community ambulators with unilateral LLA. Classification of VSI was determined based on a time-based pass/fail mCTSIB performance. Participants were classified as having normal sensory integration (NSI) if they could balance for 30 seconds in every mCTSIB condition. Participants who failed condition 4 exclusively were classified as IVSI. Prosthetic mobility, as measured by the cTUG, was compared between NSI and IVSI groups. Results Of the 130 participants, 29 (22%) were classified as IVSI and 95 (73%) were classified as having NSI. Prosthetic mobility significantly differed between IVSI and NSI groups, with IVSI participants performing all components of the cTUG significantly slower. Medium to large effect sizes were found between groups during cTUG. Conclusions These results suggest that 1 in 5 community ambulators with LLA have IVSI, with associated limitations in balance confidence and prosthetic mobility. Impact The ability to integrate vestibular information was found to have a strong relationship with prosthetic mobility in active community ambulators with LLA, especially with performing a 180-degree step turn. Physical therapists can use the mCTSIB to classify sensory integration during prosthetic rehabilitation and develop an appropriate balance intervention. Lay Summary Active adults with LLA can use information from their senses to maintain their standing balance. Adults with LLA who have difficulty balancing on foam with closed eyes were slower to get in and out of a chair, walk, and perform a 180-degree step turn.

The timed “up and go” test: Reliability and validity in persons with unilateral lower limb amputation

1999 ◽  
Vol 80 (7) ◽  
pp. 825-828 ◽  
Author(s):  
Tanneke Schoppen ◽  
Annemarijke Boonstra ◽  
Johan W. Groothoff ◽  
Jaap de Vries ◽  
Ludwig N.H. Göeken ◽  
...  
Keyword(s):  
Lower Limb ◽  
Reliability And Validity ◽  
Lower Limb Amputation ◽  
Test Reliability ◽  
Limb Amputation ◽  
Timed Up And Go

Prostheses Use and Satisfaction among People with Lower-limb Amputation in 10 districts of Bhutan

2019 ◽  
Vol 5 (2) ◽  
pp. 21-27
Author(s):  
Ugyen Norbu ◽  
Tandin Zangpo ◽  
Jit Bahadur Darnal ◽  
Hari Prasad Pokhrel ◽  
Roma Karki
Keyword(s):  
Service Delivery ◽  
Lower Limb ◽  
Cross Sectional Study ◽  
Functional Mobility ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Cross Sectional ◽  
Face To Face ◽  
Level Of Satisfaction ◽  
Lower Limb Prostheses

Introduction: The use of lower-limb prostheses restores functional mobility and improves quality of life for people with lower limb amputation. However, the use of prostheses is significantly impacted by users’ satisfaction with their prostheses and service delivery. Therefore, the excellence of prosthetic rehabilitation is not only assessed by the number of prostheses users but is also determined by the level of satisfaction with the prostheses and services received. The study was conducted to determine prostheses use and satisfaction among people with lower-limb amputation. Methods: A cross-sectional study was conducted among lower-limb prosthetic users in 10 districts of Bhutan. Data was collected by face-to-face interview using the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST) questionnaire. Participants were recruited by purposive sampling. Results: The study found that 96.4% of persons with lower-limb amputation currently used prostheses and 79% of them have used it for more than 7 hours/day. However, 44% of prostheses needed repair. The total QUEST score of satisfaction was 4.0 (SD 0.5). Conclusion: Majority of lower-limb prostheses are in use and the users reported being quite satisfied with their prostheses and service delivery. The study recommends initiating follow-up services to improve prosthetic use and overall satisfaction scores for both prostheses and service delivery.

scholarly journals Disability, economic and work-role status of individuals and their families in Bangladesh, post-unilateral lower-limb amputation (LLA) and pre-rehabilitation: a cross-sectional study

2021 ◽  
Author(s):  
Md Shapin Ibne Sayeed ◽  
Jodi Oakman ◽  
Michael P. Dillon ◽  
Rwth Stuckey
Keyword(s):  
Lower Limb ◽  
Rural Areas ◽  
Cross Sectional Study ◽  
Lower Limb Amputation ◽  
World Health ◽  
Limb Amputation ◽  
Mobility Impairment ◽  
Cross Sectional ◽  
Gendered Roles ◽  
The Impact

Abstract Background To quantify disability, occupation and socioeconomic status of individuals and their families in Bangladesh, post-unilateral lower-limb amputation (LLA) and pre-rehabilitation. Methods Between November 2017 and February 2018, people with unilateral LLA attending two XXX prosthetic rehabilitation centres were surveyed prior to rehabilitation, using the World Health Organization Disability Assessment Schedule (WHODAS-2.0) with additional socio-economic questions. Data was analysed descriptively, and cross-tabulation conducted with Chi-square test and Fisher’s exact tests. Results Seventy-six individuals participated. The majority had transtibial amputation (61.8%) from trauma (64.5%), were young adults (37.92 ± 12.35 years), in paid work prior to LLA (80%), married (63.2%), male (81.6%), from rural areas (78.9%), with primary/no education (72.4%). After LLA, mobility (WHODAS score 74.61 ± 13.19) was the most negatively affected domain. Most (60.5%) participants did not return to a paid or unpaid occupation. Acute healthcare costs negatively impacted most families (89.5%), and over 80% became impoverished. Nearly 70% of previous income-earners became economically dependent resulting in changes to traditional family roles. Conclusions Following LLA, most participants experienced significant mobility impairment, were unable to return to paid occupation and became economically dependent. The study population presents with many different characteristics from other people with LLA globally, which suggest with timely rehabilitation a return to paid employment is possible. The impact of LLA extends beyond the individual, including to families, many of whom face challenges with changes to traditional primary earner gendered roles. Improved access to timely and affordable rehabilitation is required to reduce the significant personal and societal costs of disability after LLA.

Preoperative characteristics and functional outcomes of lower limb amputees treated at Southern Älvsborg Hospital, Sweden

2013 ◽  
Vol 37 (4) ◽  
pp. 298-304 ◽  
Author(s):  
Maria Glemne ◽  
Nerrolyn Ramstrand ◽  
Jessica Crafoord ◽  
Linus Nygren
Keyword(s):  
Lower Limb ◽  
Functional Outcomes ◽  
Daily Practice ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Clinical Practices ◽  
Timed Up And Go ◽  
Significant Difference ◽  
Research Findings ◽  
Lower Limb Amputees

Background:Within the prosthetics profession, there is a lack of evidence to support many clinical practices. It is therefore important that clinicians systematically document and evaluate their daily practices.Objectives:To record preoperative characteristics and functional outcomes for patients with a lower limb amputation and to investigate variations between prosthetic users and non-prosthetic users.Study Design:Prospective cohort study.Methods:A total of 23 patients (mean age = 80 years, standard deviation = 7.3) who underwent a major lower limb amputation were assessed within 2 weeks of admission and 6 months post-operatively. Locomotor Capabilities Index-5, the Timed-Up-and-Go Test and prosthetic use were used to evaluate functional outcomes.Results:A total of 13 participants (57%) received a prosthesis within 6 months of amputation. Mean time to prosthetic fitting was 48 days (range = 28–97). No statistically significant difference was found between prosthetic users and non-prosthetic users regarding age, time to rehabilitation and Locomotor Capabilities Index-5 (p > 0.05). Locomotor Capabilities Index-5 basic was significantly lower at 6 months than prior to amputation (p = 0.039).Conclusion:The functional outcome at 6 months indicates a sizable restriction in mobility among lower limb amputees. No variation in preoperative characteristics between prosthetic users and non-prosthetic users could be confirmed in this study.Clinical relevanceThis study highlights the need for prosthetists to better incorporate research findings into their daily practice and presents an example of how to implement a procedure for assessment and documentation of patients’ functional outcomes in a clinical setting. Results confirm difficulties in identifying amputees who will become prosthetic users based on preoperative characteristics.

Selecting a test for the clinical assessment of balance and walking capacity at the definitive fitting state after unilateral amputation: a comparative study

2012 ◽  
Vol 36 (4) ◽  
pp. 415-422 ◽  
Author(s):  
Vincent Gremeaux ◽  
Sabeur Damak ◽  
Odile Troisgros ◽  
Amine Feki ◽  
Davy Laroche ◽  
...  
Keyword(s):  
Lower Limb ◽  
Pearson Correlation ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Clinical Test ◽  
Functional Evaluation ◽  
Score Distribution ◽  
Timed Up And Go ◽  
Walking Capacity ◽  
Functional Reach Test

Background:There is a lack of data and consensus concerning the most appropriate functional evaluation in clinical practice at the definitive prosthetic phase after lower limb amputation.Objectives:To determine among several selected functional tests the most pertinent to evaluate balance and prosthetic walking.Study Design:Validation of a diagnostic procedure.Methods:Sixty-four patients were included. Outcome measures: Timed Up and Go test, Functional Reach test (FRT), one-leg balance, tandem test, Modified Houghton Scale, Berg Balance Scale, two-minute walk test (2MW test). Correlations were assessed with the Pearson correlation coefficient and the Principal Component Analysis. Score distribution was analyzed with the Shapiro-Wilk W normality test. Receiver operating characteristic curves were drawn to identify the best predictor for the function.Results:The clinical tests correlated highly with each other. Only 2MW test and FRT did not have either a floor/ceiling effect, or a bi-modal distribution. The 2MW test was the best predictor of prosthetic walking limitations (area under the curve 0.93 (0.83–0.97), the best threshold was between 130 and 150 meters), and FRT was best for balance.Conclusions:2MW test can be proposed as the first-line clinical test. The FRT can be indicated for the specific assessment of balance disorders.Clinical relevanceThis validation of a clinical evaluation of balance and walking capacity after lower limb amputation may be useful in everyday practice to ensure in a simple and standardized way the follow-up of patients and adapt treatments – especially prosthetics – at the definitive prosthetic phase.

scholarly journals ESTABLISHING THE RELIABILITY AND VALIDITY OF THE COMPONENT TIMED-UP-AND-GO TEST TO DETERMINE BASIC PROSTHETIC MOBILITY IN PEOPLE WITH LOWER LIMB AMPUTATION

2018 ◽  
Author(s):  
Sheila Clemens ◽  
Ignacio Gaunaurd ◽  
Jennifer Lucarevic ◽  
Glenn Klute ◽  
Neva Kirk-Sanchez ◽  
...  
Keyword(s):  
Lower Limb ◽  
Convergent Validity ◽  
Reliability And Validity ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Timed Up And Go ◽  
National Assembly ◽  
Sit To Stand ◽  
Time Required ◽  
Test Retest Reliability

INTRODUCTION Studies suggest that brief bouts of activity consisting of sit-to-stand transitions, gait initiation, turning and negotiation of obstacles, are essential tasks of daily mobility, as well as prosthetic mobility1,2. Using outcome measures deemed reliable for use in the amputee population is ideal3,4. The purpose of this study was to investigate the reliability and validity of a component timed-up-and-go test (cTUG), using a mobile application (App), to evaluate basic prosthetic mobility tasks in people with lower limb amputation (LLA). The cTUG captures time required to perform the subtask components of sit to stand transitions, linear gait, and a 180˚ turn that are requisites of the standard TUG test. It was hypothesized that the cTUG would demonstrate test-retest reliability, differentiate between groups based on anatomical level of amputation, and exhibit convergent validity with other measures of prosthetic mobility and balance. Abstract PDF  Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/32036/24452 How to cite: Clemens S, Gaunaurd I, Lucarevic J, Klute G, Kirk-Sanchez N, Bennett C, Gailey R. ESTABLISHING THE RELIABILITY AND VALIDITY OF THE COMPONENT TIMED-UP-AND-GO TEST TO DETERMINE BASIC PROSTHETIC MOBILITY IN PEOPLE WITH LOWER LIMB AMPUTATION. CANADIAN PROSTHETICS & ORTHOTICS JOURNAL, VOLUME 1, ISSUE 2, 2018; ABSTRACT, ORAL PRESENTATION AT THE AOPA’S 101ST NATIONAL ASSEMBLY, SEPT. 26-29, VANCOUVER, CANADA, 2018. DOI: https://doi.org/10.33137/cpoj.v1i2.32036 Abstracts were Peer-reviewed by the AOPA 2018 National Assembly Scientific Committee. 

Prevalence and Factors Associated with Lower Limb Amputation in Patients Hospitalized for Diabetic Foot: a Cross-sectional Study

2020 ◽  
Vol 16 ◽  
Author(s):  
Abdourahmane Ndong ◽  
Jacques Noel Tendeng ◽  
Mohamed Lamine Diao ◽  
Diatou Gueye Dia ◽  
Amadou Diop Dia ◽  
...  
Keyword(s):  
Lower Limb ◽  
Univariate Analysis ◽  
Cross Sectional Study ◽  
Male Gender ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated ◽  
Stage D

Background: Diabetes is the leading cause of non-traumatic amputation of the lower limb. Several factors associated with amputation are described in the literature, but they remain not well studied in our context. Objectives: Our aim is to determine the prevalence and factors associated with amputation in patients hospitalized for diabetic foot. Methods: This is a prospective cross-sectional study performed over the period from December 1, 2017 to June 30, 2018. The patients included were those hospitalized for trophic disorders of the foot in patients with type 2 diabetes. The studied parameters were: epidemiological, diagnostic, therapeutic and evolutionary data. An univariate analysis and then a binary logistic regression identified the factors associated with lower limb amputation. Results: We included 53 patients. A lower limb amputation was performed in 8 patients (prevalence of 15.1%). Univariate analysis found as factors associated with major amputation: advanced age (p = 0.031); male gender (p = 0.003); use of traditional treatment (p = 0.036); non-compliance with the diabetic diet (p = 0.016); stage D of the University of Texas (UT) Classification (p = 0.029); grade ≥ 2 of the UT Classification (p = 0.002). Logistic regression finds only the following two variables as independent factor associated with amputation: male gender (p = 0.004, OR = 36.1 and CI = 3.2-402.9); stage D of the UT classification (p = 0.014, OR = 21.3 and CI = 1.8-244.2). Conclusion: Controlling these factors would allow better management of diabetes to avoid complications.

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