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Highsmith MJ, Miro RM, Kartel M, Ramrattan A, Courtade A, Heckman JT, Phillips SL, Wurdeman SR, DiBello TV, England DL, Stevens PM, Campbell JH, Hyre MJ, Maikos JT, Hill OT, Carey SL. Functional and perceptive differences between conventional and advanced ankle foot orthoses in community ambulators post-limb trauma: the injuries managed with advanced bracing of the lower extremity (IM ABLE) study. FRONTIERS IN REHABILITATION SCIENCES 2024; 5:1277509. [PMID: 39011087 PMCID: PMC11246986 DOI: 10.3389/fresc.2024.1277509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 05/15/2024] [Indexed: 07/17/2024]
Abstract
Introduction Many military service members and civilians suffer from lower extremity trauma. Despite recent advancements in lower limb bracing technology, it remains unclear whether these newer advanced braces offer improved comfort and functionality compared to conventional options. The IDEO (Intrepid Dynamic Exoskeletal Orthosis), a type of "advanced" orthosis was developed to assist in maintaining high functional performance in patients who have experienced high-energy lower extremity trauma and underwent limb salvage surgeries. Methods A cross-sector multi-site initiative was completed to study the efficacy of advanced ankle foot orthoses (AFO) for lower limb trauma and injury compared to a conventional AFO. Following fitting, training, and accommodation, the subjects were assessed in each AFO system for mobility, self-reported function, safety and pain, and preference. Results They preferred the advanced over the conventional AFO and the mobility and exertion perception improved with the advanced AFO with no difference in pain or overall health status scores. Discussion Thus, an advanced AFO is an option for trauma affecting the lower limb. Long-term studies are required to better understand the accommodation and learning process of using an advanced AFO.
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Affiliation(s)
- M. Jason Highsmith
- School of Physical Therapy & Rehabilitation Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL, United States
- Orthotic, Prosthetic & Pedorthic Clinical Services (OPPCS) Program Office, Rehabilitation & Prosthetic Services, (12RPS4) US Department of Veterans Affairs, Washington, DC, United States
| | - Rebecca M. Miro
- School of Physical Therapy & Rehabilitation Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL, United States
| | - Michael Kartel
- Orthotic, Prosthetic & Pedorthic Clinical Services (OPPCS), Physical Medicine & Rehabilitation, James A. Haley Veterans' Hospital, US Department of Veterans Affairs, Tampa, FL, United States
| | - Anita Ramrattan
- Research and Development Services, James A. Haley Veterans' Hospital, US Department of Veterans Affairs, Tampa, FL, United States
| | - Angela Courtade
- Southeastern Regional Amputation System of Care, (ASoC) Physical Medicine & Rehabilitation, James A. Haley Veterans' Hospital, US Department of Veterans Affairs, Tampa, FL, United States
| | - Jeffrey T. Heckman
- Southeastern Regional Amputation System of Care, (ASoC) Physical Medicine & Rehabilitation, James A. Haley Veterans' Hospital, US Department of Veterans Affairs, Tampa, FL, United States
- Department of Neurology, Morsani College of Medicine, University of South Florida, Tampa, FL, United States
| | - Samuel L. Phillips
- Research and Development Services, James A. Haley Veterans' Hospital, US Department of Veterans Affairs, Tampa, FL, United States
| | - Shane R. Wurdeman
- Hanger Institute for Clinical Research and Education, Austin, TX, United States
| | - Thomas V. DiBello
- Hanger Institute for Clinical Research and Education, Austin, TX, United States
| | - Dwiesha L. England
- Hanger Institute for Clinical Research and Education, Austin, TX, United States
| | - Phillip M. Stevens
- Hanger Institute for Clinical Research and Education, Austin, TX, United States
| | - James H. Campbell
- Hanger Institute for Clinical Research and Education, Austin, TX, United States
| | - Michael J. Hyre
- Narrows Institute for Biomedical Research and Education, New York, NY, United States
| | - Jason T. Maikos
- Prosthetics and Sensory Aids Services, (PSAS) New York Harbor Healthcare System, US Department of Veterans Affairs, New York, NY, United States
| | - Owen T. Hill
- School of Health Professions, College of Medicine, Health Science Center, University of Texas, San Antonio, TX, United States
| | - Stephanie L. Carey
- Department of Mechanical Engineering, College of Engineering, University of South Florida, Tampa, FL, United States
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Mellema M, Gjøvaag T. Energy expenditure during typical household and community activities of daily living in persons with lower limb amputation: A pilot study. Prosthet Orthot Int 2024; 48:258-266. [PMID: 37708342 DOI: 10.1097/pxr.0000000000000287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 07/20/2023] [Indexed: 09/16/2023]
Abstract
INTRODUCTION Knowledge about the energy expenditure of typical activities of daily living (ADL) in persons with lower limb amputation (LLA) is lacking. This study investigated the following: (1) oxygen consumption per unit distance (V̇O 2 ; mL·kg -1 ·min -1 ), (2) proportion utilization of peak oxygen consumption (%V̇O 2 peak), (3) oxygen cost (energy cost; mL·kg -1 ·m -1 ), and (4) perceived exertion (rating of perceived exertion) of ADL in persons with LLA and able-bodied controls. METHODS Participants (21 with LLA/12 controls) performed 2 household ADL experiments: in-house walking and vacuuming and 3 community ADL experiments: marked shopping, fast walking, and stair negotiation. V̇O 2 peak was assessed with arm crank ergometry, and ambulatory activity was monitored for 7 days with a StepWatch. RESULTS Participants with LLA performed in-house walking, marked shopping, vacuuming, and stair negotiation at a similar V̇O 2 as controls, while their self-selected walking speed (WS) was significantly lower. Participants with LLA had significantly higher %V̇O 2 peak than controls during in-house walking and reported a significantly higher rating of perceived exertion for vacuuming and marked shopping. The highest possible WS of participants with LLA during fast walking was significantly lower than that of controls, but V̇O 2 was also significantly lower, indicating a limited capacity to walk at higher WS. Participants with LLA had a significantly lower daily step count, significantly lower-proportion high-intensity ambulation, but significantly higher-proportion low-intensity ambulation than controls, indicating that persons with LLA also walked at lower WS in daily life. CONCLUSIONS The results indicate that persons with LLA have increased physical and perceived effort during performance of ADL compared with persons without amputation, which has consequences for community participation, and hence independence and quality of life.
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Affiliation(s)
- Mirjam Mellema
- Department of Rehabilitation Science and Health Technology, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
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Hjermundrud V, Hilding GF, Gjøvaag T. Four weeks of inpatient comprehensive prosthetic rehabilitation achieves contrasting results in different groups of prosthetic users. Prosthet Orthot Int 2024:00006479-990000000-00221. [PMID: 38377280 DOI: 10.1097/pxr.0000000000000324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 11/17/2023] [Indexed: 02/22/2024]
Abstract
BACKGROUND This study explored how inpatient exercise rehabilitation affected prosthetic mobility, function, and ambulation in persons with lower limb loss. METHODS In this explorative prospective nonrandomized intervention study, experienced (EXP-INT, n = 20) and new prosthetic users (NEW-INT, n = 18) completed a 4-week rehabilitation intervention. A control group of experienced prosthetic users (n = 19) received no intervention. Tests were performed at baseline (pretest) and after 4 weeks (posttest). A step-monitoring device recorded ambulatory activity. RESULTS For the primary outcome measure, Prosthetic Limb Users Survey of Mobility, the between-group analysis revealed significant differences (χ2 = 10.91, df = 2, p < 0.01). Within-group Prosthetic Limb Users Survey of Mobility T-scores improved by 8.1% for the EXP-INT (p < 0.01) and 15.1% for NEW-INT (p < 0.01). Significant between-group differences were observed for the Amputee Mobility Predictor, L-test, 2-minute walk test, and 10-meter walk test. Within-group analysis demonstrated nonsignificant changes for the EXP-INT except for Prosthetic Limb Users Survey of Mobility, while the NEW-INT improved by 24.1% (p < 0.001), 34.0% (p < 0.01), 46.5% (p < 0.05), and 31.0% (p < 0.01), respectively. The number of steps during the last 7 d of rehabilitation showed significant differences between the groups (χ2 = 13.99, df = 2, p < 0.001). The NEW-INT improved by 138% (p < 0.05) compared with the first 7 d of rehabilitation, while the EXP-INT had nonsignificant changes. CONCLUSIONS A 4-week rehabilitation intervention substantially increased prosthetic mobility, function, and ambulation activity for new prosthetic users but less so for experienced users. The results of the NEW-INT at discharge signify a considerable functional improvement.
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Affiliation(s)
- Vegar Hjermundrud
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
| | | | - Terje Gjøvaag
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
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Cimorelli A, Patel A, Karakostas T, Cotton RJ. Validation of portable in-clinic video-based gait analysis for prosthesis users. Sci Rep 2024; 14:3840. [PMID: 38360820 PMCID: PMC10869722 DOI: 10.1038/s41598-024-53217-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 01/30/2024] [Indexed: 02/17/2024] Open
Abstract
Despite the common focus of gait in rehabilitation, there are few tools that allow quantitatively characterizing gait in the clinic. We recently described an algorithm, trained on a large dataset from our clinical gait analysis laboratory, which produces accurate cycle-by-cycle estimates of spatiotemporal gait parameters including step timing and walking velocity. Here, we demonstrate this system generalizes well to clinical care with a validation study on prosthetic users seen in therapy and outpatient clinics. Specifically, estimated walking velocity was similar to annotated 10-m walking velocities, and cadence and foot contact times closely mirrored our wearable sensor measurements. Additionally, we found that a 2D keypoint detector pretrained on largely able-bodied individuals struggles to localize prosthetic joints, particularly for those individuals with more proximal or bilateral amputations, but after training a prosthetic-specific joint detector video-based gait analysis also works on these individuals. Further work is required to validate the other outputs from our algorithm including sagittal plane joint angles and step length. Code for the gait transformer and the trained weights are available at https://github.com/peabody124/GaitTransformer .
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Affiliation(s)
| | - Ankit Patel
- Department of Neuroscience, Baylor College of Medicine, Houston, USA
- Department of Electrical & Computer Engineering, Rice University, Houston, USA
| | - Tasos Karakostas
- Shirley Ryan AbilityLab, Chicago, USA
- Department of Physical Medicine and Rehabilitation, Northwestern University, Evanston, USA
| | - R James Cotton
- Shirley Ryan AbilityLab, Chicago, USA.
- Department of Physical Medicine and Rehabilitation, Northwestern University, Evanston, USA.
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Clemens SM, Kershaw KN, Bursac Z, Lee SP. Association of Race, Ethnicity, and Gender to Disparities in Functional Recovery and Social Health After Major Lower Limb Amputation: A Cross-sectional Pilot Study. Arch Phys Med Rehabil 2024; 105:208-216. [PMID: 37866483 PMCID: PMC11190847 DOI: 10.1016/j.apmr.2023.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 09/19/2023] [Accepted: 10/02/2023] [Indexed: 10/24/2023]
Abstract
OBJECTIVE To assess if evidence of disparities exists in functional recovery and social health post-lower limb amputation. DESIGN Race-ethnicity, gender, and income-based group comparisons of functioning and social health in a convenience sample of lower limb prosthetic users. SETTING Prosthetic clinics in 4 states. PARTICIPANTS A geographically diverse cohort of 56 English and Spanish speaking community-dwelling individuals with dysvascular lower limb amputation, between 18-80 years old. INTERVENTIONS None. MAIN OUTCOMES MEASURES Primary outcomes included 2 physical performance measures, the Timed Up and Go test and 2-minute walk test, and thirdly, the Prosthetic Limb Users Survey of Mobility. The PROMIS Ability to Participate in Social Roles and Activities survey measured social health. RESULTS Of the study participants, 45% identified as persons of color, and 39% were women (mean ± SD age, 61.6 (9.8) years). People identifying as non-Hispanic White men exhibited better physical performance than men of color, White women, and women of color by -7.86 (95% CI, -16.26 to 0.53, P=.07), -10.34 (95% CI, -19.23 to -1.45, P=.02), and -11.63 (95% CI, -21.61 to -1.66, P=.02) seconds, respectively, on the TUG, and by 22.6 (95% CI, -2.31 to 47.50, P=.09), 38.92 (95% CI, 12.53 to 65.30, P<.01), 47.53 (95% CI, 17.93 to 77.13, P<.01) meters, respectively, on the 2-minute walk test. Income level explained 14% and 11% of the variance in perceived mobility and social health measures, respectively. CONCLUSIONS Study results suggest that sociodemographic factors of race-ethnicity, gender, and income level are associated with functioning and social health post-lower limb amputation. The clinical effect of this new knowledge lies in what it offers to health care practitioners who treat this patient population, in recognizing potential barriers to optimal recovery and quality of life. More work is required to assess lived experiences after amputation and provide better understanding of amputation-related health disparities.
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Affiliation(s)
- Sheila M Clemens
- Department of Physical Therapy, Florida International University, Miami, FL.
| | - Kiarri N Kershaw
- Department of Preventive Medicine, Northwestern University, Chicago, IL
| | - Zoran Bursac
- Department of Biostatistics, Florida International University, Miami, FL
| | - Szu Ping Lee
- Department of Physical Therapy, Univeristy of Nevada, Las Vegas, NV
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Wall A, Palmcrantz S, Borg J, Gutierrez-Farewik EM. Gait pattern after electromechanically-assisted gait training with the Hybrid Assistive Limb and conventional gait training in sub-acute stroke rehabilitation-A subsample from a randomized controlled trial. Front Neurol 2023; 14:1244287. [PMID: 37885482 PMCID: PMC10598624 DOI: 10.3389/fneur.2023.1244287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 09/26/2023] [Indexed: 10/28/2023] Open
Abstract
Introduction Electromechanically-assisted gait training has been introduced in stroke rehabilitation as a means to enable gait training with a large number of reproducible and symmetrical task repetitions, i.e. steps. However, few studies have evaluated its impact on gait pattern functions. This study includes persons with no independent ambulation function at the start of a 4-week neurorehabilitation period in the sub-acute phase after stroke. The primary aim of the study was to evaluate whether the addition of electromechanically-assisted gait training to conventional training resulted in better gait pattern function than conventional training alone. The secondary aim was to identify correlations between overall gait quality and standardized clinical assessments. Participants and methods Seventeen patients with no independent ambulation function who participated in a Prospective Randomized Open Blinded End-point study in the sub-acute phase after stroke were randomized into two groups; one group (n = 7) to undergo conventional training only (CONV group) and the other group (n = 10) to undergo conventional training with additional electromechanically-assisted gait training (HAL group). All patients were assessed with 3D gait analysis and clinical assessments after the 4-week intervention period. Overall gait quality as per the Gait Profile Score (GPS), as well as kinematic, and kinetic and other spatiotemporal metrics were collected and compared between intervention groups. Correlations between biomechanical and clinical outcomes were evaluated. Results Both the CONV and HAL groups exhibited similar gait patterns with no significant differences between groups in any kinematic, kinetic parameters or other spatiotemporal metrics. The GPS for the paretic limb had a median (IQR) of 12.9° (7.8°) and 13.4° (4.3°) for the CONV and HAL groups, respectively (p = 0.887). Overall gait quality was correlated with independence in walking, walking speed, movement function and balance. We found no added benefit in gait pattern function from the electromechanically-assisted gait training compared to the conventional training alone. Discussion This finding raises new questions about how to best design effective and optimal post-stroke rehabilitation programs in patients with moderate to severe gait impairments to achieve both independent walking and optimal gait pattern function, and about which patients should be in focus in further studies on the efficacy of electromechanically-assisted gait training. Clinical trial registration The study was retrospectively registered at ClinicalTrials.gov, identifier (NCT02410915) on April 2015.
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Affiliation(s)
- Anneli Wall
- Department of Rehabilitation Medicine Stockholm, Danderyd Hospital, Stockholm, Sweden
| | - Susanne Palmcrantz
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Jörgen Borg
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Elena M. Gutierrez-Farewik
- KTH MoveAbility Lab, Department of Engineering Mechanics, Royal Institute of Technology, Stockholm, Sweden
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
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Murray L, McGinty G. Use of Physical Activity Measures in Rehabilitation Interventions Following Lower Extremity Amputation. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2023. [DOI: 10.1007/s40141-023-00383-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
Abstract
Purpose of Review
This systematic review aims to evaluate physical performance outcome tools that are used most frequently to assess rehabilitation interventions. The scope of this paper focused on outcomes used with established lower limb amputees when assessing interventions such as exercise programs or changes in prescription published in the last 5 years.
Recent Findings
The most recorded outcome measures used across all the papers were timed walk tests and the Activity Balance Confidence Scale. Many outcomes did not produce statistically significant results with established amputee cohorts. Understanding the minimal important clinical difference is key.
Summary
The use of outcome measures is essential. Training and education are likely to increase the use of outcome measures. Quality of life measures are important in conjunction with physical outcomes. Simple timed walk tests are commonly used. These are in general easy to administer requiring a small space, limited equipment, and a short time frame.
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Ikeda AJ, Hurst EJ, Simon AM, Finucane SB, Hoppe-Ludwig S, Hargrove LJ. The impact of added mass placement on metabolic and temporal-spatial characteristics of transfemoral prosthetic gait. Gait Posture 2022; 98:240-247. [PMID: 36195049 DOI: 10.1016/j.gaitpost.2022.09.086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 08/20/2022] [Accepted: 09/25/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Despite prosthetic technology advancements, individuals with transfemoral amputation have compromised temporal-spatial gait parameters and high metabolic requirements for ambulation. It is unclear how adding mass at different locations on a transfemoral prosthesis might affect these outcomes. Research question Does walking with mass added at different locations on a transfemoral prosthesis affect temporal-spatial gait parameters and metabolic requirements compared to walking with no additional mass? METHODS Fourteen participants with unilateral transfemoral amputations took part. A 1.8 kg mass was added to their prostheses in three locations: Knee, just proximal to the prosthetic knee; Shank, mid-shank on the prosthesis; or Ankle, just proximal to the prosthetic foot. Temporal-spatial gait parameters were collected as participants walked over a GAITRite® walkway and metabolic data were collected during treadmill walking for each of these conditions and with no mass added, the None condition. Separate linear mixed effects models were created and post-hoc tests to compare with the control condition of None were performed with a significance level of 0.05. RESULTS Overground self-selected walking speed for Ankle was significantly slower than for None (p < 0.05) (None: 1.16 ± 0.24; Knee: 1.15 ± 0.19; Shank: 1.14 ± 0.24; Ankle 0.99 ± 0.20 m/s). Compared to None, Ankle showed significantly increased oxygen consumption during treadmill walking (p < 0.05) (None: 13.82 ± 2.98; Knee: 13.83 ± 2.82; Shank: 14.30 ± 2.89; Ankle 14.56 ± 2.99 ml O2/kg/min). Other metabolic outcomes (power, cost of transport, oxygen cost) showed similar trends. Knee and Shank did not have significant negative effects on any metabolic or temporal-spatial parameters, as compared to None (p > 0.05). Significance Results suggest that additional mass located mid-shank or further proximal on a transfemoral prosthesis may not have negative temporal-spatial or metabolic consequences. Clinicians, researchers, and designers may be able to utilize heavier components, as long as the center of mass is not further distal than mid-shank, without adversely affecting gait parameters or metabolic requirements.
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Affiliation(s)
- Andrea J Ikeda
- Regenstein Center for Bionic Medicine, Shirley Ryan AbilityLab, Chicago, IL, USA.
| | - Emily J Hurst
- Regenstein Center for Bionic Medicine, Shirley Ryan AbilityLab, Chicago, IL, USA
| | - Ann M Simon
- Regenstein Center for Bionic Medicine, Shirley Ryan AbilityLab, Chicago, IL, USA; Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, IL, USA
| | - Suzanne B Finucane
- Regenstein Center for Bionic Medicine, Shirley Ryan AbilityLab, Chicago, IL, USA
| | - Shenan Hoppe-Ludwig
- Regenstein Center for Bionic Medicine, Shirley Ryan AbilityLab, Chicago, IL, USA
| | - Levi J Hargrove
- Regenstein Center for Bionic Medicine, Shirley Ryan AbilityLab, Chicago, IL, USA; Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, IL, USA; Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA
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Clemens SM, Kershaw KN, McDonald CL, Darter BJ, Bursac Z, Garcia SJ, Rossi MD, Lee SP. Disparities in functional recovery after dysvascular lower limb amputation are associated with employment status and self-efficacy. Disabil Rehabil 2022:1-8. [PMID: 35723056 DOI: 10.1080/09638288.2022.2087762] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE Employment status is considered a determinant of health, yet returning to work is frequently a challenge after lower limb amputation. No studies have documented if working after lower limb amputation is associated with functional recovery. The study's purpose was to examine the influence of full-time employment on functioning after lower limb amputation. METHODS Multisite, cross-sectional study of 49 people with dysvascular lower limb amputation. Outcomes of interest included performance-based measures, the Component Timed-Up-and-Go test, the 2-min walk test, and self-reported measures of prosthetic mobility and activity participation. RESULTS Average participant age was 62.1 ± 9.7 years, 39% were female and 45% were persons of color. Results indicated that 80% of participants were not employed full-time. Accounting for age, people lacking full-time employment exhibited significantly poorer outcomes of mobility and activity participation. Per regression analyses, primary contributors to better prosthetic mobility were working full-time (R2 ranging from 0.06 to 0.24) and greater self-efficacy (R2 ranging from 0.32 to 0.75). CONCLUSIONS This study offers novel evidence of associations between employment and performance-based mobility outcomes after dysvascular lower limb amputation. Further research is required to determine cause-effect directionalities. These results provide the foundation for future patient-centered research into how work affects outcomes after lower limb amputation. IMPLICATIONS FOR REHABILITATIONLower limb amputation can pose barriers to employment and activity participation, potentially affecting the quality of life.This study found that the majority of people living with lower limb amputation due to dysvascular causes were not employed full-time and were exhibiting poorer prosthetic outcomes.Healthcare practitioners should consider the modifiable variable of employment when evaluating factors that may affect prosthetic mobility.The modifiable variable of self-efficacy should be assessed by healthcare professionals when evaluating factors that may affect prosthetic mobility.
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Affiliation(s)
- Sheila M Clemens
- Department of Physical Therapy, Florida International University, Miami, FL, USA
| | - Kiarri N Kershaw
- Department of Preventive Medicine, Northwestern University, Chicago, IL, USA
| | - Cody L McDonald
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Benjamin J Darter
- Department of Physical Therapy, Virginia Commonwealth University, Richmond, VA, USA
| | - Zoran Bursac
- Department of Biostatistics, Florida International University, Miami, FL, USA
| | - Stephanie J Garcia
- Department of Biostatistics, Florida International University, Miami, FL, USA
| | - Mark D Rossi
- Department of Physical Therapy, Florida International University, Miami, FL, USA
| | - Szu Ping Lee
- Department of Physical Therapy, University of Nevada, Las Vegas, Las Vegas, NV, USA
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Evidence-Based Amputee Rehabilitation: a Systematic Approach to the Restoration of Function in People with Lower Limb Loss. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2022. [DOI: 10.1007/s40141-021-00335-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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