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Prosthetic fitting, use, and satisfaction following lower-limb amputation: a prospective study.
Joseph B Webster1, Kevin N Hakimi, Rhonda M Williams
1Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA. joseph.webster@va.gov
Journal of Rehabilitation Research and Development
|March 22, 2013
Summary
Most individuals achieve successful prosthetic fitting after lower-limb amputation. However, factors like depression, diabetes, and pain impact prosthetic use and function, highlighting the need for comprehensive rehabilitation strategies.
Area of Science:
- Rehabilitation Medicine
- Prosthetics and Orthotics
- Amputee Care
Background:
- Successful prosthetic fitting is crucial for lower-limb amputation rehabilitation.
- Understanding factors influencing prosthetic use and satisfaction is essential.
Purpose of the Study:
- To determine the rate of successful prosthetic fitting within 12 months post-amputation.
- To describe prosthetic utilization patterns after lower-limb amputation.
- To identify factors associated with prosthetic fitting, function, and satisfaction.
Main Methods:
- Multicenter prospective cohort study.
- Inclusion of first-time major lower-limb amputations due to vascular disease and/or diabetes.
- Assessment of prosthetic fitting, use, function, and satisfaction at various time points.
Main Results:
- 92% of subjects achieved prosthetic fitting by 12 months.
- Unsuccessful fitting at 4 months linked to depression, prior arterial reconstruction, diabetes, and residual limb pain.
- Transfemoral amputations were associated with lower fitting rates.
- Older age, depression, and renal dialysis history correlated with reduced prosthetic walking hours.
- Older age, depression, and COPD were associated with greater functional restriction.
Conclusions:
- While most lower-limb amputees achieve prosthetic fitting within a year, specific medical and psychosocial factors significantly influence outcomes.
- Addressing depression, pain, and comorbidities is vital for optimizing prosthetic use and function.
- Individualized rehabilitation approaches are necessary to improve prosthetic outcomes for diverse patient populations.
