Article

OBJECTIVE: To describe physical function outcomes and modes of physical therapy
intervention for a cohort of patients with dysvascular lower extremity amputation
(LEA) during the prosthetic training phase of rehabilitation. DESIGN: A retrospective cohort study. SETTING: Physical rehabilitation clinics at a
Veterans Affairs medical center and a university hospital. PATIENTS: Forty-two
patients (38 men, 4 women, age 60.2 +/- 8.4 years) who completed outpatient
physical therapy rehabilitation with prosthetic training after dysvascular LEA.
METHODS: All patients underwent a prosthetic training phase of rehabilitation,
with standardized outcome measures performed at initiation and discharge. MAIN
OUTCOME MEASURES: Performance-based physical function measures included
Two-Minute Walk (2MW), Timed-Up and Go (TUG), and 5-meter gait speed. Self-report
physical function measures included the Prosthesis Evaluation
Questionnaire-Mobility Section (PEQ-MS) and the Patient-Specific Functional
Scale. Rehabilitation dose was tracked as total number of clinic visits,
rehabilitation duration, and specific intervention modes. RESULTS: There were
significant improvements between initial and discharge values (mean +/- SD) for
the Two-Minute Walk (67.5 +/- 29.9 m and 103.3 +/- 45.8 m, respectively, P <
.001), gait speed (0.58 +/- 0.27 m/s and 0.88 +/- 0.39 m/s, respectively, P <
.001), TUG (34.8 +/- 21.3 seconds and 18.6 +/- 13.9 seconds, respectively, P <
.001), PEQ-MS (2.2 +/- 0.9 and 2.8 +/- 0.8, respectively, P < .001), and
Patient-Specific Functional Scale (3.2 +/- 2.0 and 5.9 +/- 2.3, respectively, P <
.001). Performance-based (TUG) and self-report (PEQ-MS) changes in functional
mobility from initial exam to discharge had low or no correlations with
rehabilitation dose measures. The number of clinic visits was 12.7 +/- 13.1 and
rehabilitation duration was 13.7 +/- 16.8 weeks. CONCLUSIONS: Significant
improvements in performance-based and self-report measures of physical function
occurred during the prosthetic training phase of physical rehabilitation after
dysvascular major LEA. Despite improvements in function, gait speed, and TUG
outcomes remained below clinically important thresholds, indicating patients were
limited in community ambulation and at risk for falls. Lack of moderate or
greater correlation between rehabilitation dose and outcome measures may indicate
the need for more specific rehabilitation dose measures.
CI - Copyright (c) 2015 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc.
All rights reserved.

Langue : ANGLAIS