Factors influencing rehabilitation of arteriosclerotic lower limb amputees

This survey considered 598 arteriosclerotic amputees over a period of 9 years: 267 below-knee; 81 Gritti-Stokes; 195 above-knee; and 55 double amputees. A walking ability index (WAI) ranging from 1 for a normal gait to 6 for inability to walk was determined for these amputees by clinical grading at 3, 6, 9, and 12 months after prosthesis fitting. Amputees with the below-knee operation had better WAI at 3 and more months than those with either Gritti-Stokes or above-knee operations. There was no statistical evidence for a difference between Gritti-Stokes and above-knee operations at any time of assessment of WAI. The 50-59 year-old age group had significantly better WAI at 6, 9, and 12 months than did the 60-69 or 70+ age group, but the 60-69 year-old group was not significantly different from the 70+ age group. On an average, the 78 amputees (14 percent) with ischemic heart disease had a poorer WAI at 6 and more months than did those without it; the 46 amputees (8 percent) with hemiplegia were worse at 12 months than those without hemiplegia; and the 15 amputees (11 percent) with bronchitis were worse at 12 months than those without bronchitis. Double amputees had poorer WAIs at 12 months than those of single amputees.