Is walking maintained following discharge from prosthetic rehabilitation?

Abstract

PURPOSE: To determine if people who walked with a lower limb prosthesis on discharge from rehabilitation continued to 20 weeks after discharge. MATERIALS AND METHODS: An observational cohort study design. People with major lower extremity amputation (LEA) who were discharged from rehabilitation using a prosthesis to walk and were due for prosthetic review appointment (20 weeks following discharge) during the period of data collection were eligible to be included. The primary outcome was the continuation of walking with a lower limb prosthesis at this time point (T2). Secondary outcome measures were: Timed Up and Go (TUG), Two Minute Walk Test (2MWT), SIGAM score, Locomotor Capability Index-5 (LCI-5), and Orthotic Prosthetic User Survey- Quality of Life (OPUS-QOL). Secondary outcomes were assessed at time of discharge from rehabilitation (T1) and repeated at T2. Statistical analysis was carried out comparing the results of the secondary outcome measures at T1 and T2. RESULTS: 22/28 participants were still walking with their prostheses at T2. Five of the six who abandoned walking with their prostheses did so because of issues with the skin on their residuum or contralateral foot. Participants who continued to walk with their prostheses demonstrated a statistically significant improvement in TUG (5.01 seconds, p < 0.01) and 2MWT (11.35 metres, p < 0.01) between the two time points. No statistically significant difference was found in LCI-5 or OPUS QOL scores between the two time points. CONCLUSION: Most participants continued to walk with their prosthesis and experienced further improvements in their exercise tolerance and decrease in their risk of falls after discharge.