Extent of artificial limb use following rehabilitation

The extent of prosthesis use is reported for 104 lower limb amputees from the onset of gait training up to 2 years later. Subjects were divided into groups according to age (greater than or equal to 65 years or less than 65 years) and amputation level. An analysis of variance including the factors of age and level of amputation was done. Unilateral trans-tibial (UTT) amputees progressed more quickly during the inpatient gait training program that did unilateral trans-femoral (UTF) subjects (p less than 0.05). UTT subjects also walked more than UTF subjects just prior to discharge (p less than 0.05), during the first year after discharge (p less than 0.01), and during the second year after discharge (p less than 0.01). Similarly, younger patients progressed more quickly in gait training (p less than 0.05) and walked more than older subjects throughout the study period (p less than 0.05). There were no significant interactions between age and amputation. The extent of walking of these amputees is compared with the minimal levels required for them to function in different living environments. At the time of discharge from the inpatient gait training program, older unilateral amputees and trans-femoral amputees were not able to walk the 600 steps a day necessary to manage with a moderate level of support in a one-level apartment or home. The declining number of steps taken in the follow-up period indicated that the UTF subjects might benefit from some special attention paid to their community support needs. These findings are also viewed in the context of limited data available on the extent of walking of non-amputees.