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Mobility Analysis of AmpuTees II: Comorbidities and Mobility in Lower Limb Prosthesis Users
Shane R Wurdeman1, Phillip M Stevens, James H Campbell
1From the Department of Clinical and Scientific Affairs, Hanger Clinic, Austin, Texas (SRW, PMS, JHC); Department of Biomechanics, University of Nebraska, Omaha, Nebraska (SRW); and Division of Physical Medicine & Rehabilitation, University of Utah, Salt Lake City, Utah (PMS).
Objective:
The aim of the study was to determine the impact of comorbidities on mobility in patients with lower limb prostheses.
Design:
Cohort database chart review was conducted to examine mobility in lower limb prosthesis users grouped according to comorbidities. Regression models were used to determine significant predictor comorbidities for mobility. General linear univariate models were implemented to investigate differences in mobility among cohorts (N = 596).
Results:
Patient age and history of stroke, peripheral vascular disease, and anxiety/panic disorders were predictors of decreased mobility. After adjusting for covariates, the differences in mobility reported by patients older than 65 yrs was compared with those younger than 65 yrs; in addition, we compared those with a history of peripheral vascular disease with those without. The comparative analyses for both categories did not satisfy the minimal clinically important difference. There were no significant differences when comparing overall comorbid health after adjusting for covariates.
Conclusions:
Clinicians should consider patient age and history of stroke, peripheral vascular disease, or anxiety/panic disorders when optimizing a lower limb prosthesis users' mobility because these variables may be predictive of modest but clinically meaningful decreased prosthetic mobility. By contrast, common comorbid health conditions such as arthritis, chronic obstructive pulmonary disease, congestive heart failure, and diabetes do not seem predictive of decreased mobility among lower limb prosthesis users.
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