Webster JB, Hakimi KN, Williams RM, Turner AP, Norvell DC, Czerniecki JM, et al.
Journal of rehabilitation research and development. Date of publication 2012 Jan 1;volume 49(10):1493-504.
1. J Rehabil Res Dev. 2012;49(10):1493-504.
Prosthetic fitting, use, and satisfaction following lower-limb amputation: a
prospective study.
Webster JB(1), Hakimi KN, Williams RM, Turner AP, Norvell DC, Czerniecki JM.
Author information:
(1)Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA,
USA. joseph.webster@va.gov
Providing a satisfactory, functional prosthesis following lower-limb amputation
is a primary goal of rehabilitation. The objectives of this study were to
describe the rate of successful prosthetic fitting over a 12 mo period; describe
prosthetic use after amputation; and determine factors associated with greater
prosthetic fitting, function, and satisfaction. The study design was a
multicenter prospective cohort study of individuals undergoing their first major
lower-limb amputation because of vascular disease and/or diabetes. At 4 mo,
unsuccessful prosthetic fitting was significantly associated with depression,
prior arterial reconstruction, diabetes, and pain in the residual limb. At 12 mo,
92% of all subjects were fit with a prosthetic limb and individuals with
transfemoral amputation were significantly less likely to have a prosthesis fit.
Age older than 55 yr, diagnosis of a major depressive episode, and history of
renal dialysis were associated with fewer hours of prosthetic walking. Subjects
who were older, had experienced a major depressive episode, and/or were diagnosed
with chronic obstructive pulmonary disease had greater functional restriction.
Thus, while most individuals achieve successful prosthetic fitting by 1 yr
following a first major nontraumatic lower-limb amputation, a number of medical
variables and psychosocial factors are associated with prosthetic fitting,
utilization, and function.
DOI: 10.1682/jrrd.2012.01.0001
PMID: 23516053 [Indexed for MEDLINE]
