Changes in mobility after community-based prosthesis fitting and rehabilitation in people with major lower limb amputations: a cohort study.

Abstract

ObjectiveTo investigate changes in mobility in adults with recent major lower limb amputation participating in community-based rehabilitation. Second, to assess the impact of amputation level (transtibial versus transfemoral) on mobility changes.DesignCohort study.SettingRehabilitation Centre in Copenhagen Municipality.SubjectsA total of 265 individuals with recent major lower limb amputations were prospectively recruited into a cohort from 2008 to 2022 as part of routine practice.MethodsFour physiotherapists collected data on age, sex, level of amputation (transtibial/transfemoral) and assessed mobility at start of walking out of parallel handrail (baseline) and at the end (follow-up) of rehabilitation. Mobility was assessed with the Timed-Up-and-Go test, 10-Meter Walk test, and 2-Minute Walk test. The impact of amputation level was analyzed using multivariable linear regression adjusted for age and sex.ResultsA total of 199 individuals (153 men) mean age of 64.9 (standard deviation 12.2) years had baseline and follow-up mobility data and were eligible for the study. Mobility significantly improved on all tests for individuals with both amputation levels after community rehabilitation. Multivariable analysis showed that individuals with transfemoral amputations on average improved with 17.9 seconds more (95% confidence interval: 12.7-23.1) than transtibial completing the Timed-Up-and-Go test. Contrary, transtibial walked 0.11 meter/second faster (95% confidence interval: 0.02-0.20) and 7.2 meters (95% confidence interval: -1.4 to 15.8) longer in the 10-Meter Walk test and 2-Minute Walk test respectively than transfemoral amputees.ConclusionAdults with lower limb amputations improved their mobility significantly from baseline to follow-up. Individuals with transfemoral amputations improved more than transtibial amputations on functional mobility.