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Predicting prosthetic use in elderly patients after major lower limb amputation
Monica Spruit- van Eijk1, Harmen van der Linde, Bianca Buijck
1Department of Primary and Community Care, Centre for Family Medicine, Geriatric Care and Public Health, Radboud University Nijmegen, Medical Centre, the Netherlands. m.spruit-vaneijk@elg.umcn.nl
Elderly patients with lower limb amputation in skilled nursing facilities (SNFs) have a high likelihood of prosthetic use if they can walk independently after a transtibial amputation and do not experience phantom limb pain. This finding aids in prosthetic training decisions.
Area of Science:
- Geriatric rehabilitation
- Prosthetic outcomes
- Amputation management
Background:
- Limited research exists on factors influencing prosthetic use and mobility in elderly patients with multiple health conditions (multimorbidity) undergoing rehabilitation after lower limb amputation in skilled nursing facilities (SNFs).
- Existing literature on prosthetic use determinants primarily focuses on younger amputees.
Purpose of the Study:
- To predict prosthetic use and physical mobility in geriatric patients rehabilitated in SNFs post-lower limb amputation.
- To assess the impact of multimorbidity on prosthetic use and physical mobility outcomes.
Main Methods:
- Prospective study design.
- Utilized univariate and multivariate logistic and linear regression analyses.
- Identified independent determinants for prosthetic use and the Timed-Up-and-Go (TUG) test performance.
Main Results:
- Fifty percent of the 38 patients with complete assessments received a prosthesis.
- Independent ambulation, transtibial amputation level, and absence of phantom pain were significant predictors of prosthetic use (R²=56%).
- Cognitive function, lower amputation level, and pre-operative functional status were independently associated with TUG test results (R²=82%).
Conclusions:
- Elderly patients in SNFs with lower limb amputations who can ambulate independently after a transtibial amputation and without phantom pain demonstrate a high probability of successful prosthetic use.
- These patient characteristics suggest they are suitable candidates for prosthetic training programs.
