Article

OBJECTIVE: To review the evidence connecting risk factors to falls in adults with
a lower limb amputation (LLA) across the continuum of care settings. DESIGN:
Systematic review. LITERATURE SURVEY: Electronic database searches were conducted
in MEDLINE, Pubmed, CINAHL, and EMBASE covering January 1988 to January 2016.
Noninterventional studies, including cohort and cross-sectional studies, were
included. Two reviewers independently completed data extraction and quality
evaluation. METHODOLOGY: Twelve studies met the inclusion criteria and quality of
reporting was evaluated using the criteria by Tooth et al. SYNTHESIS: The average
quality of reporting score was 19.8, scores ranged from 16 to 29. Studies covered
the acute hospital stay after the amputation, inpatient rehabilitation, and
community living. Falls were a common occurrence, with the cohort studies
reporting 20.8% for acute hospital stay to 58% in the community years after the
amputation. Injurious falls also were common, with an occurrence ranging from 40%
to 60%. Risk factors that increase falls and are shared with the general
population of older adults include lower extremity muscle weakness, increasing
age, comorbidities, and number of prescription medications. Risk factors for
falls that are unique to adults with LLA are dysvascular etiology of the
amputation, transtibial level of amputation in the postoperative period and
transfemoral level postrehabilitation, and reduced sense of vibration.
CONCLUSIONS: Falls in adults with an LLA are common from the time of the
amputation to years later living in the community. Risk factors vary across care
settings after the amputation, which has implications for safety and
fall-prevention strategies. LEVEL OF EVIDENCE: III.
CI - Copyright (c) 2017 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS