An eight-year analysis of participant characteristics at admission to inpatient prosthetic rehabilitation following a lower limb amputation: a Canadian perspective

Ashvene Sureshkumar; Michael W Payne; Ricardo Viana; Susan W Hunter

doi:10.1080/09638288.2023.2240231

An eight-year analysis of participant characteristics at admission to inpatient prosthetic rehabilitation following a lower limb amputation: a Canadian perspective

Disabil Rehabil. 2023 Jul 27:1-11. doi: 10.1080/09638288.2023.2240231. Online ahead of print.

Authors

Ashvene Sureshkumar¹, Michael W Payne^{2

3}, Ricardo Viana^{2

3}, Susan W Hunter^{1

3

4}

Affiliations

¹ University of Western Ontario, London, Ontario, Canada.
² Department of Physical Medicine & Rehabilitation, Parkwood Institute London, Ontario, Canada.
³ Department of Physical Medicine & Rehabilitation, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, Canada.
⁴ School of Physical Therapy, University of Western Ontario, London, Ontario, Canada.

PMID: 37498002
DOI: 10.1080/09638288.2023.2240231

Abstract

Purpose: To describe admission and discharge characteristics of participants admitted to prosthetic rehabilitation following a lower limb amputation and determine changes in participant characteristics including if the population has gotten older over time at admission.

Methods: A retrospective chart audit of consecutive admissions to an amputee rehabilitation program. Study criteria were transtibial level LLA and above and ≥ 18 years old. Admission characteristics included: age, Montreal Cognitive Assessment (MoCA), Functional Comorbidity Index (FCI) and days between amputation surgery and admission. Discharge characteristics included the L -Test of Functional Mobility (L-Test), 2-Minute Walk Test (2MWT), 6-Minute Walk Test (6MWT), and Activities-specific Balance Confidence (ABC) scale. Multivariable linear regression modelling quantified the association between participant characteristics and admission time.

Results: A total of 601 participants (62.3 ± 14.1 years) were included, 63 were (84.9 ± 3.7 years) aged 80 and over. FCI scores [β = 70.34, (95% CI: 20.93, 119.74), p = 0.005] and days between amputation surgery [β = -0.08, (95% CI: -0.13, -0.02), p = 0.011] were independently associated with admission time.

Conclusion: People with an LLA are presenting with a higher number of comorbidities at admission over time while being admitted faster from amputation surgery. Future research should investigate the impact of these changing characteristics on rehabilitation outcomes to better assist this population.

Keywords: Lower limb amputation; mobility; oldest old; participant characteristics; rehabilitation.

Plain language summary

It is expected that the rate of inpatient prosthetic rehabilitation admissions due to lower limb amputations will increase amongst those over eighty.An analysis of participant characteristics of people admitted to inpatient prosthetic rehabilitation over time will inform modification and developments to future programs.Future prosthetic rehabilitation programs should consider an increased number of comorbidities when developing prognostic expectations for participants.A shortened interval between amputation surgery and admission should be considered when developing prosthetic rehabilitation programs.