Is Walking Maintained after Discharge from Prosthetic Rehabilitation?

Introduction: The incidence of lower limb amputation in Ireland is rising due to increased prevalence of diabetes and an aging population. Walking is a common goal of patients who are admitted for prosthetic rehabilitation, however very little is known about whether this goal is maintained after discharge in the Irish setting.

Aim: The aim of this study was to determine if walking is maintained after discharge from prosthetic rehabilitation.

Methods: Patients discharged from a national prosthetic rehabilitation centre were recruited at the time of their prosthetic review appointment and consent obtained. Data on assessments conducted on discharge and patient demographics were extracted from medical records. It was determined if the participants were still walking with a prosthesis at time of review. If walking was maintained outcome measures completed on discharge including Timed Up and Go (TUG), 2 Minute Walk Test (2MWT) and Locomotor Capabilities Index-5 (LCI-5) were repeated. Statistical analysis was completed and data was described using descriptive statistics. Data was tested for normal distribution and the difference between measures at the two time points was tested. Validation of a previously developed clinical prediction rule in this population was explored using information extracted from the participant’s health care record.

Results: Of the 28 participants who were included in the study 22 (78.6 %) were still walking at the time of review. For five of those who were no longer walking the reason was issues with skin on their residuum or remaining foot, two of these participants I underwent further amputation. For those who were still walking at the time of review there was a statistically significant improvement in 2MWT and TUG from discharge to review. The clinical prediction rule was not found to predict prosthetic non-use in this sample.

Implications of Findings: The results suggest that increased emphasis on management of skin and chronic conditions is required as part of the rehabilitation programme.

Conclusion: Walking was maintained for the majority of people after discharge from

prosthetic rehabilitation.