Functional outcome of rehabilitated bilateral lower limb amputees

The functional outcome of rehabilitated bilateral lower limb amputees was studied. The study included 31 amputees who were admitted during 1980–1990 to a rehabilitation centre in the north of the Netherlands. The clinical notes made during the patients' admission were studied to obtain information about their characteristics, while mobility and prosthetic use were studied at discharge. The patients who were alive and willing to participate in the study were interviewed by a physician at their residence in November 1992, using among other things, the Sickness Impact Profile (SIP) and the Life Satisfaction questionnaire. Some 25 of the 31 patients were amputated for vascular reasons, 1 patient primarily for traumatic reasons and secondarily for vascular reasons, 5 patients for traumatic reasons. Eight patients had a bilateral trans-femoral amputation, 18 patients a bilateral trans-tibial amputation, 2 patients a combination of transtibial and knee-disarticulation amputation, 3 patients a trans-femoral/trans-tibial amputation. Mean age at second amputation was 66.3 years. Of the 31 amputees 21 were men and 10 women, 25 amputees were prosthetically rehabilitated during admission, 3 of them died during admission and 5 did not achieve mobility at discharge. In their activities of daily life 22 of the 28 patients alive at discharge were almost independent. At the time of the follow-up evaluation 17 of the 31 patients had died. For several reasons only 8 patients could be included in the follow-up, 6 vascular amputees and 2 traumatic amputees. Six of the 8 patients were prosthetically rehabilitated at discharge, but only 2 of them used their prosthesis at the time of follow-up, 1 vascular and 1 traumatic amputee. The SIP showed high levels of impairment for ambulation, mobility, body care/movement, work and home mqnagement. In the Life Satisfaction questionnaire all patients reported to be rather satisfied to very satisfied with life.

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Do work ability and life satisfaction matter for return to work? Predictive ability of the work ability index and life satisfaction questionnaire among women with long-term musculoskeletal pain

BMC Public Health ◽

10.1186/s12889-021-10510-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Mamunur Rashid ◽

Marina Heiden ◽

Annika Nilsson ◽

Marja-Leena Kristofferzon

Keyword(s):

Life Satisfaction ◽

Back Pain ◽

Sick Leave ◽

Work Ability ◽

Work Ability Index ◽

Discriminative Ability ◽

Satisfaction Questionnaire ◽

Ability Index

Abstract Background Impaired work ability and reduced life satisfaction due to long-term musculoskeletal pain, particularly in neck, shoulders and back, are considered occupational health problems that can result in workers taking sick leave. The aim of the study was to determine whether work ability and life satisfaction predict return to work (RTW) among women with long-term neck/shoulder and/or back pain, and to assess the ability of the Work Ability Index (WAI) and the Life Satisfaction Questionnaire (LiSat-11) to discriminate between those who did RTW and those who did not RTW (NRTW). Methods This is a cohort study with 1-year follow-up. A survey was sent to 600 women receiving sick leave benefits from the Swedish Social Insurance Agency. In total, 208 women responded at baseline, and 141 at a 1-year follow-up. To identify whether work ability and life satisfaction predicted RTW, multiple logistic regression analyses were performed with and without adjustment for type of work and pain intensity. To assess the discriminative ability of the WAI and the LiSat-11 for women who did RTW and those who did NRTW, receiver operating characteristic curves were fitted. Results Work ability predicted RTW, and the results remained significant after adjusting for type of work and pain intensity (OR 1.12, 95% CI: 1.04–1.22). Life satisfaction was not significant. The WAI at baseline adequately discriminated between RTW and NRTW after 1 year (Area under curve 0.78, 95% CI: 0.70–0.86), but the LiSat-11 did not. Conclusions This study supports a relationship between work ability and RTW among women on sick leave for long-term neck/shoulder and/or back pain. The results indicate that the WAI, but not the LiSat-11, can discriminate between RTW and NRTW in the population under study. Although the discriminative ability of the WAI needs to be verified in new samples before it can be recommended for use in rehabilitation settings, we suggest that healthcare professionals consider how women perceive their work ability in order to better support them in their RTW.

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Clinical Features and Outcomes Following Bilateral Lower Limb Amputation in Korea

Prosthetics and Orthotics International ◽

10.1080/03093640600608074 ◽

2006 ◽

Vol 30 (2) ◽

pp. 155-164 ◽

Cited By ~ 5

Author(s):

Ji Cheol Shin ◽

Eun Joo Kim ◽

Chang Il Park ◽

Eun Sook Park ◽

Kyoo-Ho Shin

Keyword(s):

Clinical Features ◽

Lower Limb ◽

Daily Living ◽

Lower Limb Amputation ◽

Limb Amputation ◽

Medical Problems ◽

Amputation Level ◽

Significant Difference ◽

Bilateral Lower Limb ◽

Lower Limb Amputees

The objectives of this study were to evaluate the clinical features and outcomes of 43 bilateral lower limb amputees. The clinical features obtained included the causes of amputation, level of amputation, concurrent medical problems, and stump condition. Outcome measures were obtained using the activities of daily living (ADL) index, the Frenchay Activities Index (FAI), and mobility grading with prostheses or wheelchair. Of 33 amputees who were prosthetic ambulators, 22 (67%), mainly bilateral trans-tibial (TT) amputees, were community ambulators, and participated in activities which included stair-walking, and six of 11 household ambulators were combination trans-femoral (TF) and TT amputees. Of 10 amputees who were wheelchair ambulators, only one was able to perform wheelchair transfers independently and five were independent wheelchair ambulators. Using the ADL index and FAI, there was no significant difference in scores according to the level of amputation ( p > 0.05), but the scores of community prosthetic ambulators were significantly higher than those of wheelchair ambulators ( p < 0.05). Age was found to be negatively correlated with ADL index and FAI scores ( r = −0.518 vs. r = −0.550) ( p < 0.01). This study concludes that overall independence in ADL after bilateral lower limb amputation improved with young age and prosthetic mobility.

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Mobility, prosthesis use and health-related quality of life of bilateral lower limb amputees from the 2008 Sichuan earthquake

Prosthetics and Orthotics International ◽

10.1177/0309364618792720 ◽

2018 ◽

Vol 43 (1) ◽

pp. 104-111 ◽

Cited By ~ 4

Author(s):

Wing Sum Li ◽

Sze Ying Chan ◽

Wai Wang Chau ◽

Sheung-wai Law ◽

Kai Ming Chan

Keyword(s):

Quality Of Life ◽

Lower Limb ◽

Sichuan Earthquake ◽

Factors Associated ◽

Rehabilitation Outcomes ◽

Related Quality ◽

Health Related ◽

Bilateral Lower Limb ◽

Lower Limb Amputees

Background: The 2008 Sichuan Earthquake resulted in many amputees, yet due to the rare incidence, few studies have explored the rehabilitation outcomes and quality of life of bilateral lower limb amputees after major natural disasters. Objectives: To evaluate rehabilitation outcomes of 17 young and adult bilateral lower limb amputees under the StandTall rehabilitation programme and to identify factors associated with successful functional recovery of bilateral amputees after large-scale disasters. Study Design: Cross-sectional study. Methods: Mobility (amputee mobility predictor), prosthesis use (Houghton Scale) and health-related quality of life (Trinity Amputation and Prosthesis Experience Scale, Short Form 12) were evaluated through questionnaires and performance-based assessments. Means of scores were compared using T-tests. Results: Subjects with bilateral through-knee or transtibial amputations had less activity restriction ( p < 0.01) and higher mobility ( p = 0.03). Subjects using prostheses more than 50% waking time had better general adjustment ( p = 0.02) and less functional restriction ( p = 0.01). Exercise and education were associated with higher mobility ( p = 0.06) and mental quality of life, respectively ( p = 0.09). Conclusions: Amputation level and knee joint salvage, prosthesis use, exercise and education were associated with better rehabilitation outcomes including ambulation, adjustment and quality of life in bilateral lower limb amputees from the 2008 Sichuan Earthquake. Clinical relevance The study examined a unique group of traumatic bilateral lower limb amputees who were young and healthy before having traumatic amputations from a single episode of natural disaster. The factors associated with better functional recovery after the earthquake were investigated and may support future development of post-disaster rehabilitation strategies for bilateral lower limb amputees.

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Percutaneous Endoscopic Interlaminar Unilateral Ventral Dural Approach for Symptomatic Bilateral L5–S1 Herniated Nucleus Pulposus: Technical Note

Journal of Neurological Surgery Part A Central European Neurosurgery ◽

10.1055/s-0038-1639505 ◽

2018 ◽

Vol 79 (06) ◽

pp. 518-523 ◽

Cited By ~ 5

Author(s):

Sung Choi ◽

Nitin Adsul ◽

Ki Kim ◽

Jeong Kim ◽

Sung Chung ◽

...

Keyword(s):

Nucleus Pulposus ◽

Lower Limb ◽

Leg Pain ◽

Limb Pain ◽

Lumbar Disk Herniation ◽

Interlaminar Approach ◽

Lower Limb Pain ◽

Bilateral Lower Limb ◽

Herniated Nucleus Pulposus

Background Percutaneous endoscopic lumbar diskectomy is a good treatment modality for lumbar disk herniation. However, when a patient complains of bilateral lower limb radicular pain with severe disk protrusion at the L5–S1 level, the transforaminal approach is often unable to resolve both lesions owing to anatomical limitations. It is also very difficult to resolve both lesions in an ipsilateral direction using the percutaneous interlaminar approach. We report our surgical technique and clinical results using a ventral dural approach of percutaneous endoscopic interlaminar lumbar diskectomy for L5–S1 herniated nucleus pulposus (HNP) in patients with bilateral radiculopathy due to a severe disk protrusion. Methods Twenty-seven patients with severe L5–S1 HNP complaining of back pain and bilateral lower limb pain were included in the study. The unilateral ventral dural approach of percutaneous full endoscopic interlaminar lumbar diskectomy technique was used. The visual analog scale (VAS) and Macnab criteria were used for clinical evaluation. All assessments were completed 1 day before surgery, 1 week after surgery, 6 months after surgery, and at final follow-up after surgery. Results The mean preoperative back and leg pain VAS scores decreased from 5.67 ± 0.78 and 7.81 ± 0.83 to 2.44 ± 0.58 and 2.26 ± 0.53 at 1 week, 1.78 ± 0.51 and 1.52 ± 0.58 at 6 months, and 1.56 ± 0.70 and 1.67 ± 0.96, respectively, at the final follow-up after surgery. With respect to the Macnab criteria, 51.85% of the results were excellent, 44.44% were good, and 3.70% were fair. Four cases recurred: three patients underwent conservative treatment and one patient operated with percutaneous endoscopic interlaminar lumbar diskectomy. Conclusion According to the results of this study, the ventral dural approach of percutaneous full endoscopic interlaminar lumbar diskectomy in patients with L5–S1 HNP associated with bilateral lower limb pain due to a severely protruded HNP is a good option for a minimally invasive surgical approach.

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Lower urinary tract dysfunction in acute disseminated encephalomyelitis

Multiple Sclerosis Journal ◽

10.1177/1352458509106614 ◽

2009 ◽

Vol 15 (9) ◽

pp. 1118-1122 ◽

Cited By ~ 15

Author(s):

JN Panicker ◽

D Nagaraja ◽

JME Kovoor ◽

KPS Nair ◽

DK Subbakrishna

Keyword(s):

Urinary Tract ◽

Functional Outcome ◽

Lower Limb ◽

Lower Urinary Tract ◽

Voiding Dysfunction ◽

Acute Disseminated Encephalomyelitis ◽

Neurological Deficits ◽

Lower Urinary Tract Dysfunction ◽

Lower Urinary

Background Lower urinary tract dysfunction (LUTD) in multiple sclerosis has been well documented. However, its occurrence and outcome in acute disseminated encephalomyelitis (ADEM) has only been variably reported. Objective To evaluate LUTD in ADEM, correlation with other neurological deficits, and outcome. Methods Patients with ADEM having significant LUTD were evaluated. LUTD was evaluated by symptom analysis, ultrasonography, and urodynamics. Storage symptoms were managed using antimuscarinics and significant voiding dysfunction by catheterization. Results Of 61 patients, 20 (33%) had LUTD. Voiding dysfunction was more common and 16 patients were in urinary retention. Cystometry demonstrated detrusor overactivity in four patients and underactivity in four patients. Incontinence was reported more often in patients with frontoparietal white matter changes in MR imaging. LUTD was found to be associated with occurrence of paraparesis or tetraparesis, though did not predict functional outcome at discharge. At 3 months follow up, five patients continued to have LUTD and urgency and hesitancy were commonest symptoms. Conclusion LUTD is common in ADEM, especially in patients with lower limb pyramidal involvement and its causes multifactorial. Presence of LUTD does not influence the functional outcome of patients with ADEM. Recovery may be incomplete and symptoms may persist even after recovery of other neurological deficits.

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