Search

Background:: The relationship between gait speed and prosthetic potential (K-level classifications) and function has not been explored among people transitioning from hospital rehabilitation to the community., Objectives:: To examine gait speed at discharge from inpatient rehabilitation among people prescribed a prosthetic leg after unilateral lower limb amputation, and associations between gait speed, prosthetic potential and functional ability., Study Design:: Cohort., Methods:: Gait speed (10-m walk test), K-level (Amputee Mobility Predictor) and Functional Independence Measure motor were compared for 110 people (mean (standard deviation) age: 63 (13) years, 77% male, 71% transtibial amputation, 70% dysvascular causes)., Results:: Median (interquartile range) gait speed and Functional Independence Measure motor were 0.52 (0.37-0.67) m/s and 84 (81, 85), respectively. Median (IQR) gait speed scores for each K-level were as follows: K1 = 0.17 (0.15-0.19) m/s, K2 = 0.38 (0.25-0.54) m/s, K3 = 0.63 (0.50-0.71) m/s and K4 = 1.06 (0.95-1.18) m/s. Median (IQR) FIM-Motor scores for each K-level were as follows: K1 = 82 (69-84), K2 = 83 (79-84), K3 = 85 (83-87) and K4 = 87 (86-89). Faster gait speed was associated with higher K-level, higher FIM-Motor, being younger, male and having transtibial amputation with nonvascular aetiology., Conclusion:: Gait speed was faster among each higher K-level classification. However, gait speeds observed across all K-levels were slower than healthy populations, consistent with values indicating high risk of morbidity and mortality., Clinical Relevance: Factors associated with faster gait speed are useful for clinical teams considering walking potential of people with lower limb prostheses and those seeking to refine prosthetic rehabilitation programmes.

Objective: To examine personal and social demographics, and rehabilitation discharge outcomes of dysvascular and non-vascular lower limb amputees., Methods: In total, 425 lower limb amputation inpatient rehabilitation admissions (335 individuals) from 2005 to 2011 were examined. Admission and discharge descriptive statistics (frequency, percentages) were calculated and compared by aetiology., Results: Participants were male (74%), aged 65 years (s.d. 14), born in Australia (72%), had predominantly dysvascular aetiology (80%) and a median length of stay 48 days (interquartile range (IQR): 25-76). Following amputation, 56% received prostheses for mobility, 21% (n = 89) changed residence and 28% (n = 116) required community services. Dysvascular amputees were older (mean 67 years, s.d. 12 vs 54 years, s.d. 16; P < 0.001) and recorded lower functional independence measure--motor scores at admission (z = 3.61, P < 0.001) and discharge (z = 4.52, P < 0.001). More non-vascular amputees worked before amputation (43% vs 11%; P < 0.001), were prescribed a prosthesis by discharge (73% vs 52%; P < 0.001) and had a shorter length of stay (7 days, 95% confidence interval: -3 to 17), although this was not statistically significant., Conclusions: Differences exist in social and demographic outcomes between dysvascular and non-vascular lower limb amputees.