Article

The purpose of this review of the scientific literature was to
investigate the incidence and prevalence of hemiplegia with lower limb
amputation, and to identify outcomes following the dual disability of hemiplegia
and amputation. METHODS: Electronic searching of the literature identified major
studies examining the effects of hemiplegia on rehabilitation following
amputation. Data were extracted and levels of evidence assigned for each subtopic
area. RESULTS: The summary conclusions are Level 4 evidence. The prevalence of
amputation and hemiplegia is 8-18% and amputation and hemiplegia occur most often
in the same leg. Once individuals with hemiplegia and lower limb amputation are
selected for prosthetic rehabilitation, rate of successful functional ambulation
is greater than 58%. In general there is a lower rate of prosthetic success and
independence with hemiplegia than without. Predictive factors associated with
success include less severe hemiplegia, laterality of hemiplegia (ipsilateral and
right side), transtibial level of amputation and absence of impaired mental
function. There is wide variation in length of hospital stay, but a specialty
multidisciplinary team reduces length of stay. CONCLUSIONS: Patients with dual
disability of hemiplegia and amputation generally benefit from a prosthetic
rehabilitation program. Further study on predictive factors for outcome would be
beneficial. IMPLICATIONS FOR REHABILITATION:
* The prevalence of hemiplegia with
lower limb amputation ranges from 8 to 18%, most frequently affecting the same leg. * The majority of patients attain successful functional levels of ambulation
with prosthetic rehabilitation, although lower rates than nonhemiplegic patients.
* Predictive factors associated with greater success include less severe
hemiplegia, ipsilateral hemiplegia, transtibial level of amputation and absence
of impaired mental function.

Langue : ANGLAIS