Weight-bearing, pain and walking velocity during primary transtibial amputee rehabilitation
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Published on: May 8, 2014
M E Jones1, G M Bashford, V V Bliokas
1Illawarra Area Health Service, Port Kembla Hospital, Warrawong, NSW, Australia. jonesm@iahs.nsw.gov.au
Objective:
To explore the relationships between weight-bearing, pain and walking velocity in the first four weeks of prosthetic training.
Subjects:
Consecutively referred transtibial amputees (n = 27).
Design:
Longitudinal study.
Setting:
Inpatient rehabilitation centre.
Interventions:
Measurements of static weight-bearing (SWB), perceived pain during the SWB test and self-selected walking velocity (VEL) were taken at entry, and at four weeks into the prosthetic training programme. Path analysis was conducted using a series of linear regression analyses to determine predictors of walking velocity at week 4.
Results:
Significant improvements from week 1 to week 4 were found in SWB, reported pain and velocity. SWB at week 4, when coupled with age, predicted 66% of the variance in walking velocity at week 4. Pain did not directly predict velocity. However, SWB at entry and perceived pain at week 4 predicted 56% of the variance in SWB at week 4.
Conclusions:
These analyses suggested a model in which SWB and age were both significantly related to velocity, and further, that pain played a role in velocity through a relationship mediated by its direct effect on SWB. Unlike age, SWB is a predictor of velocity that might be altered through pain reduction, wound-healing and rehabilitative interventions.
