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Community ambulation in people with lower limb amputation: An observational cohort study

Lower limb amputation (LLA) is still a health issue requiring rehabilitation and long-term care even in industrial societies. Several studies on subjects with LLA have been focused on the efficacy of rehabilitation and factors influencing the use of prosthesis. However, literature data on the recove...

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Autores principales: Damiani, Carlo, Pournajaf, Sanaz, Goffredo, Michela, Proietti, Stefania, Denza, Gabriele, Rosa, Benedetta, Franceschini, Marco, Casale, Roberto
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7837990/
https://www.ncbi.nlm.nih.gov/pubmed/33546072
http://dx.doi.org/10.1097/MD.0000000000024364
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author Damiani, Carlo
Pournajaf, Sanaz
Goffredo, Michela
Proietti, Stefania
Denza, Gabriele
Rosa, Benedetta
Franceschini, Marco
Casale, Roberto
author_facet Damiani, Carlo
Pournajaf, Sanaz
Goffredo, Michela
Proietti, Stefania
Denza, Gabriele
Rosa, Benedetta
Franceschini, Marco
Casale, Roberto
author_sort Damiani, Carlo
collection PubMed
description Lower limb amputation (LLA) is still a health issue requiring rehabilitation and long-term care even in industrial societies. Several studies on subjects with LLA have been focused on the efficacy of rehabilitation and factors influencing the use of prosthesis. However, literature data on the recovery of ability to walk outdoors, and thus to participate in social life in this population is limited. To investigate potential correlations between socio-demographic and clinical factors, and the use of the prosthesis for indoor and/or outdoor walking referred to as community ambulation (CA) in subjects with LLA. An observational cohort study on 687 LLA subjects was conducted. Socio-demographic and clinical characteristics of 302 subjects who received similar rehabilitative treatment with respect to the standard protocol were collected by a telephone survey with a structured questionnaire. The CA recovery, in terms of patient's autonomy and participation, assessed by Walking Handicap Scale, was considered as the main outcome. The univariate analysis demonstrated statistical significant positive correlation between CA and gender (χ(2) = 3.901, P = .048); amputation level (χ(2) = 24.657, P < .001); pre-LLA (χ(2) = 6.338, P = .012) and current work activity (χ(2) = 25.192, P < .001); prosthesis use (χ(2) = 187.037, P < .01); and time from LLA (r = 0.183, P < .001); increasing age was negatively correlated with the outcome (r = –0.329, P < .001), while pain intensity was not significant. Being male (75.4%); trans-tibial (TT) amputation level (9.79%); working before (3.81%) and after LLA (7.68%); and the prosthesis use (24.63%) increased the probability of CA recovery. Multivariate binary logistic regression analysis confirmed that the prosthesis use (P < .001) and TT amputation level (P = .042) are predictors of a positive outcome (Walking Handicap Scale 4–6). These findings highlight the importance of the use of prosthesis in people with LLA for the restoration of a good capacity of participation (CA), especially in subjects with TT amputation level. The identification of predictive factors may help tailor-made rehabilitation approaches addressing an earlier reintegration to social life.
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spelling pubmed-78379902021-01-28 Community ambulation in people with lower limb amputation: An observational cohort study Damiani, Carlo Pournajaf, Sanaz Goffredo, Michela Proietti, Stefania Denza, Gabriele Rosa, Benedetta Franceschini, Marco Casale, Roberto Medicine (Baltimore) 4400 Lower limb amputation (LLA) is still a health issue requiring rehabilitation and long-term care even in industrial societies. Several studies on subjects with LLA have been focused on the efficacy of rehabilitation and factors influencing the use of prosthesis. However, literature data on the recovery of ability to walk outdoors, and thus to participate in social life in this population is limited. To investigate potential correlations between socio-demographic and clinical factors, and the use of the prosthesis for indoor and/or outdoor walking referred to as community ambulation (CA) in subjects with LLA. An observational cohort study on 687 LLA subjects was conducted. Socio-demographic and clinical characteristics of 302 subjects who received similar rehabilitative treatment with respect to the standard protocol were collected by a telephone survey with a structured questionnaire. The CA recovery, in terms of patient's autonomy and participation, assessed by Walking Handicap Scale, was considered as the main outcome. The univariate analysis demonstrated statistical significant positive correlation between CA and gender (χ(2) = 3.901, P = .048); amputation level (χ(2) = 24.657, P < .001); pre-LLA (χ(2) = 6.338, P = .012) and current work activity (χ(2) = 25.192, P < .001); prosthesis use (χ(2) = 187.037, P < .01); and time from LLA (r = 0.183, P < .001); increasing age was negatively correlated with the outcome (r = –0.329, P < .001), while pain intensity was not significant. Being male (75.4%); trans-tibial (TT) amputation level (9.79%); working before (3.81%) and after LLA (7.68%); and the prosthesis use (24.63%) increased the probability of CA recovery. Multivariate binary logistic regression analysis confirmed that the prosthesis use (P < .001) and TT amputation level (P = .042) are predictors of a positive outcome (Walking Handicap Scale 4–6). These findings highlight the importance of the use of prosthesis in people with LLA for the restoration of a good capacity of participation (CA), especially in subjects with TT amputation level. The identification of predictive factors may help tailor-made rehabilitation approaches addressing an earlier reintegration to social life. Lippincott Williams & Wilkins 2021-01-22 /pmc/articles/PMC7837990/ /pubmed/33546072 http://dx.doi.org/10.1097/MD.0000000000024364 Text en Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0
spellingShingle 4400
Damiani, Carlo
Pournajaf, Sanaz
Goffredo, Michela
Proietti, Stefania
Denza, Gabriele
Rosa, Benedetta
Franceschini, Marco
Casale, Roberto
Community ambulation in people with lower limb amputation: An observational cohort study
title Community ambulation in people with lower limb amputation: An observational cohort study
title_full Community ambulation in people with lower limb amputation: An observational cohort study
title_fullStr Community ambulation in people with lower limb amputation: An observational cohort study
title_full_unstemmed Community ambulation in people with lower limb amputation: An observational cohort study
title_short Community ambulation in people with lower limb amputation: An observational cohort study
title_sort community ambulation in people with lower limb amputation: an observational cohort study
topic 4400
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7837990/
https://www.ncbi.nlm.nih.gov/pubmed/33546072
http://dx.doi.org/10.1097/MD.0000000000024364
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