Article

The main objective was to assess the change in the functional
independence in basic activities of daily living (ADL) following a pre-prosthetic
intervention in people with lower-limb amputation (LLA). Secondary objectives
were to identify the factors contributing to the success of this intervention,
and to analyze the effects on the presence of unmet needs for home adaptation.
METHOD: The ADL intervention was early and pre-prosthetic;
it was focused on six
self-care activities. Fifty-two adults with LLA, who required assistance in
self-care, were included. Functional independence (Barthel) was assessed at
baseline and after intervention (T2). Successful intervention was defined as
independent performance of all self-care activities.
RESULTS: There was a
significant improvement in Barthel scores between baseline and T2 in toileting (p
< 0.001), bed-chair transfers (p < 0.001), dressing (p < 0.001),
bathing/showering (p < 0.001), and feeding (p = 0.025). The proportion of homes
with an unmet need for adaptation decreased significantly in bathroom (p = 0.008)
and other internal areas (p = 0.031). Intervention was successful for 61.5% of
participants. In a multivariate model, age was significantly associated with
successful intervention (OR 0.66, 95%CI 0.52-0.83). CONCLUSIONS: A short and
pre-prosthetic ADL intervention improves functional independence and reduces the
need for home adaptation. ADL programs should be included in rehabilitation
strategies. Implications for Rehabilitation Because basic activities of daily
living (ADL) can be seriously compromised after a lower-limb amputation, it is
important for this population to improve or maintain their level of independence.
A short and pre-prosthetic ADL intervention is an effective method for an early
recovery of functional independence in self-care activities and promotes home
adaptation. Age is an important determinant of functional recovery, and most
subjects can achieve independence in basic ADL regardless of the level of
amputation. A pre-prosthetic ADL program should be included in rehabilitation
strategies for adults with lower-limb amputation.

Langue : ANGLAIS