In a seven-year analysis, researchers questioned whether the characteristics of people with lower-limb amputations changed over that period of time. Admission characteristics, including etiology, gender, age, amputation level, cognition, indoor mobility aid, motor function, number and type of comorbidities, and discharge characteristics, including prosthetic prescription, motor function, discharge mobility aid, and destination were compared by admission date and year. The researchers found that the total number of people with lower-limb amputations did not change over the seven-year study period. However, changes were observed in etiology, cognition, and motor function, and prosthetic prescription rates decreased over time.
The researchers examined 425 lower-limb amputation inpatient rehabilitation admissions (335 individuals) from 2005 to 2011. Analysis of the data showed that a proportion of people with lower-limb amputations with nonvascular etiology increased over time (from 15 percent in 2004 to 24 percent in 2011).
While admission cognition increased over time, motor function deteriorated. At admission, the median interquartile range of the Functional Independence Measure motor score was 70 (59-77) in 2005 and 67 (51.5-73.25) in 2011; at discharge it was 81 in 2005 and 79 in 2011. Prosthetic prescription rates were highest in 2005 (68 percent) decreasing to 47 percent in 2010.
The study concluded that rehabilitation should account for the changing characteristics of people with lower-limb amputations; motor function should be addressed as part of rehabilitation to optimize the patient’s ability to return home and to the community, and the reduced prescription rates for lower-limb prostheses over time indicated more specific selection processes and refined clinical decision making.
The report was published online September 5 in the Journal of Disability and Rehabilitation.
