The second part of a study of the impact of comorbidities on mobility among lower-limb prosthesis users, the Mobility Analysis of Amputees (MAAT II), was published August 27 in the American Journal of Physical Medicine & Rehabilitation. The MAAT II findings, led by the clinical and scientific affairs department of Hanger, Austin, Texas, demonstrated that a person’s overall comorbid health has little impact on his or her mobility with a lower-limb prosthesis because patients with multiple comorbidities still benefit from prosthetic devices to provide meaningful mobility.
The researchers, including James Campbell, PhD, CO, FAAOP; Shane R. Wurdeman, PhD, CP, FAAOP; and Phil M. Stevens, MEd, CPO, FAAOP, performed a retrospective review of outcomes data collected within multiple Hanger clinics. The primary endpoint included within the analysis was the Prosthetic Limb Users Survey of Mobility. Analysis included 596 current prosthesis users who were at least 18 years old with varying amputation levels and included unilateral and bilateral lower-limb amputations.
The results of the MAAT II study found only four factors to be significant predictors of mobility: age, history of stroke, presence of peripheral vascular disease (PVD), and anxiety/panic disorders. Mobility declined with compounding comorbid health conditions; however, after adjusting for age, history of stroke, PVD, and anxiety/panic disorders, there were no significant impacts of comorbid health on mobility.
The authors concluded that clinicians should consider patient age and history of stroke, peripheral vascular disease, or anxiety/panic disorders when optimizing a lower limb prosthesis users’ mobility as these variables may be predictive of modest but clinically meaningful decreased prosthetic mobility. By contrast, common comorbid health conditions such as arthritis, COPD, congestive heart failure, and diabetes do not appear predictive of decreased mobility among lower-limb prosthesis users.
“The continued rise in lower-limb amputations is creating a need for improved means of identifying patients who will benefit from prosthetic rehabilitation and technology,” said Campbell, chief clinical officer, Hanger Clinic. “In the absence of strong research support to guide prosthetic rehabilitation, decision makers have been restricted in their options for identifying prosthetic candidates. Historically, comorbid health has been among the factors utilized, despite a lack of strong evidence to support this application, which necessitated further research.”
