Physiotherapy rehabilitation for individuals with lower limb amputation: A 15-year clinical series

Brenton Hordacre, Vicki Birks, Stephen Quinn, Chris Barr, Benjamin Patritti, Maria Crotty

    Research output: Contribution to journalArticle

    15 Citations (Scopus)

    Abstract

    Background and Purpose: Individuals with amputations are a core group in Australian rehabilitation units that have a long index length of stay. The Repatriation General Hospital (RGH) offers general rehabilitation services to the population of Southern Adelaide (a population of 350,000) and includes an on-site prosthetic manufacturing facility. Using a physiotherapy database at the RGH, we sought to answer the following questions: What are the demographic and clinical characteristics of patients admitted for lower limb prosthetic rehabilitation over 15years? What are the times to rehabilitation outcomes? How have these changed over 15years with changes in service delivery? Methods: This paper is a retrospective observational study using a physiotherapy clinical database (1996-2010) of 531 consecutive individuals with lower limb amputation at one South Australian hospital (RGH). There were two changes in service delivery: 1) a multidisciplinary interim prosthetic programme (IPP) introduced in 1998 and 2) removable rigid dressings (RRDs) introduced in 2000. Outcome measures were patient demographics, clinical characteristics and time to rehabilitation outcome markers. Results: Mean age was 68years (standard deviation [SD]: 15), with 69% male, 80% dysvascular and 68% transtibial. The overall median inpatient rehabilitation length of stay (RLOS) was 39days (interquartile range [IQR]: 26-57). Individuals with amputation entering rehabilitation each year had a higher number of co-morbidities (β: 0.08; 95% confidence interval: 0.05-0.11). Introduction of the IPP was associated with a significant reduction in time to initial prosthetic casting, independent walking and inpatient RLOS. Introduction of RRDs was associated with a significant reduction in time to wound healing, initial prosthetic casting and independent walking. Conclusions: Individuals with amputation were typically elderly dysvascular men with transtibial amputations. Introduction of the IPP and RRDs successfully reduced time to rehabilitation outcomes including independent walking, an outcome that is rarely reported but is of significance to patients and physiotherapists.

    Original languageEnglish
    Pages (from-to)70-80
    Number of pages11
    JournalPhysiotherapy Research International
    Volume18
    Issue number2
    DOIs
    Publication statusE-pub ahead of print - 2013

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