Article

Providing a satisfactory, functional prosthesis following lower-limb amputation
is a primary goal of rehabilitation. The objectives of this study were to describe the rate of successful prosthetic fitting over a 12 mo period; describe
prosthetic use after amputation; and determine factors associated with greater
prosthetic fitting, function, and satisfaction. The study design was a
multicenter prospective cohort study of individuals undergoing their first major
lower-limb amputation because of vascular disease and/or diabetes. At 4 mo,
unsuccessful prosthetic fitting was significantly associated with depression,
prior arterial reconstruction, diabetes, and pain in the residual limb. At 12 mo,
92% of all subjects were fit with a prosthetic limb and individuals with
transfemoral amputation were significantly less likely to have a prosthesis fit.
Age older than 55 yr, diagnosis of a major depressive episode, and history of
renal dialysis were associated with fewer hours of prosthetic walking. Subjects
who were older, had experienced a major depressive episode, and/or were diagnosed
with chronic obstructive pulmonary disease had greater functional restriction.
Thus, while most individuals achieve successful prosthetic fitting by 1 yr
following a first major nontraumatic lower-limb amputation, a number of medical
variables and psychosocial factors are associated with prosthetic fitting,
utilization, and function.

Langue : ANGLAIS