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

Outcome measures are becoming increasingly important in health care. Functional outcome measures are of particular importance for lower limb amputees since much of the rehabilitation process is concerned with increasing mobility and personal independence. The Scottish Physiotherapy Amputee Research Group (SPARG) has used three measures of functional outcome: the Barthel Index, Russek's classification and the Locomotor Index. The review reported here involves 938 patients having a primary amputation at the transtibial or transfemoral level between October 1992 and July 1997. Differences in function due to age and level of amputation are well known clinically and the measures were compared by looking at their ability to detect these differences. The Barthel Index lacked sensitivity because of ceiling effects and should not be considered as a suitable functional outcome measure for amputee patients. Russek's classification does detect significant differences but requires a large number of patients making it unsuitable for single hospital investigations. The Locomotor Index demonstrates significant differences due to age and amputation level despite fewer patients being assessed by this measure during the period covered by this paper. The range of the Locomotor Index can be extended to cover more active amputees by considering its ‘advanced activities’ subscale separately. The Locomotor Index is a promising measure and should be considered by rehabilitation teams looking for a valid, reliable and sensitive functional outcome measure for use with lover limb amputees.

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Functional outcome in a cohort of lower limb amputees

Annals of Physical and Rehabilitation Medicine ◽

10.1016/j.rehab.2014.03.427 ◽

2014 ◽

Vol 57 ◽

pp. e121

Author(s):

A. Quesnel ◽

F. Beuret-Blanquart ◽

L. Benadiba ◽

F. Dujardin ◽

E. Verin ◽

...

Keyword(s):

Functional Outcome ◽

Lower Limb ◽

Lower Limb Amputees

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Functional outcome of lower-limb amputees: A prospective descriptive study in a general hospital

Prosthetics and Orthotics International ◽

10.3109/03093649609164423 ◽

1996 ◽

Vol 20 (2) ◽

pp. 79-87 ◽

Cited By ~ 32

Author(s):

A. C. Greive ◽

G. J. Lankhorst

Keyword(s):

Functional Outcome ◽

General Hospital ◽

Lower Limb ◽

Lower Limb Amputation ◽

Limb Amputation ◽

Diabetic Patients ◽

Functional Abilities ◽

Age Related ◽

Co Morbidity ◽

Lower Limb Amputees

This paper describes functional outcome of a population of lower limb amputees five months after amputation compared with their pre-operative functional abilities and studies the relationship between potential determinants and functional outcome. Twenty out of 26 patients who underwent a lower limb amputation between December 1993 and August 1994 in a general hospital in Amsterdam were included in the study. Their functional abilities before amputation were retrospectively assessed using an ICIDH (International Classification of Impairments, Disabilities and Handicaps)-based questionnaire. Functional outcome was assessed after amputation of the lower limb using ICIDH-based and SIP (Sickness Impact Profile)-questionnaires. The mean SIP scores were high (referring to a low functional outcome). Disabilities were spread over the five disability fields of the ICIDH. The functional outcome of the diabetic versus the non-diabetic group was lower on the physical, activities of daily living (ADL), psychological and communicative categories of the ICIDH. In most patients, functional outcome decreased. The diabetic patients compared to the non-diabetics showed more diversity in functional outcome, compared with their preoperative functional abilities. Increasing age is significantly associated with a low functional outcome on the SIP scores. Diabetes is age-related for this sample. Co-morbidity and motivation are strongly age-related for this sample. It was concluded that lower-limb amputees appear quite disabled in all disability categories of the ICIDH and as assessed by the SIP scores. In most patients, functional abilities decrease after lower limb amputation. Age seems to be a significant factor related to functional outcome.

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Factors Influencing Rehabilitation and Functional Outcome in Lower Limb Amputees.

The Japanese Journal of Rehabilitation Medicine ◽

10.2490/jjrm1963.38.125 ◽

2001 ◽

Vol 38 (2) ◽

pp. 125-130

Author(s):

Tetsuo IKAI ◽

Mikumo UEMATSU ◽

Sang Soo EUN ◽

Keiji HASHIMOTO ◽

Satoshi MIYANO

Keyword(s):

Functional Outcome ◽

Lower Limb ◽

Factors Influencing ◽

Lower Limb Amputees

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Functional outcome of rehabilitated bilateral lower limb amputees

Prosthetics and Orthotics International ◽

10.3109/03093649409164666 ◽

1994 ◽

Vol 18 (1) ◽

pp. 18-24 ◽

Cited By ~ 20

Author(s):

A. De Fretes ◽

A. M. Boonstra ◽

L. D. W. Vos

Keyword(s):

Life Satisfaction ◽

Functional Outcome ◽

Lower Limb ◽

Rehabilitation Centre ◽

Satisfaction Questionnaire ◽

The North ◽

Bilateral Lower Limb ◽

Body Care ◽

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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Adaptive Foot in Lower-Limb Prostheses

Journal of Robotics ◽

10.1155/2017/9618375 ◽

2017 ◽

Vol 2017 ◽

pp. 1-15 ◽

Cited By ~ 2

Author(s):

Thilina H. Weerakkody ◽

Thilina Dulantha Lalitharatne ◽

R. A. R. C. Gopura

Keyword(s):

Lower Limb ◽

Uneven Surface ◽

Design Concepts ◽

Human Foot ◽

Future Developments ◽

Adaptive Capabilities ◽

Adaptive Nature ◽

Lower Limb Amputees ◽

Artificial Prosthesis ◽

Lower Limb Prostheses

The human foot consists of complex sets of joints. The adaptive nature of the human foot enables it to be stable on any uneven surface. It is important to have such adaptive capabilities in the artificial prosthesis to achieve most of the essential movements for lower-limb amputees. However, many existing lower-limb prostheses lack the adaptive nature. This paper reviews lower-limb adaptive foot prostheses. In order to understand the design concepts of adaptive foot prostheses, the biomechanics of human foot have been explained. Additionally, the requirements and design challenges are investigated and presented. In this review, adaptive foot prostheses are classified according to actuation method. Furthermore, merits and demerits of present-day adaptive foot prostheses are presented based on the hardware construction. The hardware configurations of recent adaptive foot prostheses are analyzed and compared. At the end, potential future developments are highlighted.

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