Locomotor Performance During Rehabilitation of People With Lower Limb Amputation and Prosthetic Nonuse 12 Months After Discharge.
Background. It is recognized that multifactorial assessments are needed to evaluate balance and locomotor function in people with lower limb amputation. There is no consensus on whether a single screening tool could be used to identify future issues with locomotion or prosthetic use. Objective. The...
| Publicado en: | Physical Therapy Vol. 96; no. 7; pp. 985 - 995 |
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| Autores principales: | , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Oxford University Press / USA
Jul2016
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=116573674&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 116573674 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00319023 PTH jtl: Physical Therapy issn: 00319023 maglogo: N pubinfo: dt: Jul2016 vid: 96 iid: 7 pid: 10398 pub: Oxford University Press / USA artinfo: ui: 116573674 116573674 116573674 10.2522/ptj.20140164 116573674 ppf: 985 ppct: 10 formats: fmt: @attributes: type: P tig: atl: Locomotor Performance During Rehabilitation of People With Lower Limb Amputation and Prosthetic Nonuse 12 Months After Discharge. aug: au: Roffman, Caroline E. Buchanan, John Allison, Carry T. affil: School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth, Western Australia 6845, Australia sug: subj: Below-Knee Amputation Rehabilitation Locomotion Evaluation Limb Prosthesis Utilization Above-Knee Amputation Rehabilitation Time Factors Exercise Test Western Australia Comorbidity Clinical Assessment Tools Amputees Classification Demography Prospective Studies Mann-Whitney U Test ROC Curve Relative Risk P-Value Confidence Intervals Interviews Record Review Middle Age Female Male Human Funding Source Middle Aged: 45-64 years Female Male ab: Background. It is recognized that multifactorial assessments are needed to evaluate balance and locomotor function in people with lower limb amputation. There is no consensus on whether a single screening tool could be used to identify future issues with locomotion or prosthetic use. Objective. The purpose of this study was to determine whether different tests of locomotor performance during rehabilitation were associated with significantly greater risk of prosthetic abandonment at 12 months postdischarge. Design. This was a retrospective cohort study. Method. Data for descriptive variables and locomotor tests (ie, 10-Meter Walk Test [10MWT], Timed "Up & Go" Test [TUGT], Six-Minute Walk Test [6MWT], and Four Square Step Test [FSST]) were abstracted from the medical records of 201 consecutive participants with lower limb amputation. Participants were interviewed and classified as prosthetic users or nonusers at 12 months postdischarge. The Mann-Whitney U test was used to analyze whether there were differences in locomotor performance. Receiver operating characteristic curves were generated to determine performance thresholds, and relative risk (RR) was calculated for nonuse. Results. At 12 months postdischarge, 18% (n=36) of the participants had become prosthetic nonusers. Performance thresholds, area under the curve (AUC), and RR of nonuse (95% confidence intervals [Cl]) were: for the 10MWT, if walking speed was ≤0.44 ms-1 (AUC=0.743), RR of nonuse=2.76 (95% CI=1.83, 3 79; PC.000I); for the TUGT, if time was ≥21.4 seconds (AUC=0.796), RR of nonuse=3.17 (95% CI=2.17, 4.14; PC.0001); for the 6MWT, if distance was ≤191 m (AUC=0.788), RR of nonuse=2.84, (95% CI=2.05, 3.48; P<.0001); and for the FSST, if time was ≥36.6 seconds (AUC=0.762), RR of nonuse=2.76 (95% CI=1.99, 3.39; PC.0001). Limitations. Missing data, potential recall bias, and assessment times that varied were limitations of the study. Conclusions. Locomotor performance during rehabilitation may predict future risk of prosthetic nonuse. It may be implied that the 10MWT has the greatest clinical utility as a single screening tool for prosthetic nonuse, given the highest proportion of participants were able to perform this test early in rehabilitation. However, as locomotor skills improve, other tests (in particular, the 6MWT) have specific clinical utility. To fully enable implementation of these locomotor criteria for prosthetic nonuse into clinical practice, validation is warranted. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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