Creating Adjusted Scores Targeting mobiLity Empowerment (CASTLE 1): determination of normative mobility scores after lower limb amputation for each year of adulthood

As United States healthcare transitions from traditional fee-for-service models to value-based care, there is increased need to demonstrate quality care through clinical outcomes. Therefore, the purpose of this study was to create equations to calculate an expected mobility score for lower limb pros...

Full description

Saved in:
Bibliographic Details
Published inDisability and rehabilitation Vol. 46; no. 9; p. 1904
Main Authors Fylstra, Bretta L, England, Dwiesha L, Stevens, Phillip M, Campbell, James H, Wurdeman, Shane R
Format Journal Article
LanguageEnglish
Published England 01.05.2024
Subjects
Adult
Age Factors
Aged
Amputation, Surgical - rehabilitation
Amputees - rehabilitation
Artificial Limbs
Cross-Sectional Studies
Female
Humans
Lower Extremity - surgery
Male
Middle Aged
Mobility Limitation
Retrospective Studies
United States
Young Adult
United States
value-based care
Lower-limb amputation
mobility
patient-reported outcome measures
microprocessor knee
age
Online AccessGet more information

Cover

More Information
Summary:As United States healthcare transitions from traditional fee-for-service models to value-based care, there is increased need to demonstrate quality care through clinical outcomes. Therefore, the purpose of this study was to create equations to calculate an expected mobility score for lower limb prosthesis users specific to their age, etiology, and amputation level to provide benchmarks to qualify good outcomes. A retrospective cross-sectional analysis of outcomes collected during clinical care was performed. Individuals were grouped based on amputation level (unilateral above-knee (AKA) or below-knee (BKA)) and etiology (trauma or diabetes/dysvascular (DV)). The mean mobility score (PLUS-M® T-score) for each year of age was calculated. AKAs were further stratified into having a microprocessor knee (MPK) or non-microprocessor (nMPK) for secondary analysis. As expected, average prosthetic mobility declined with age. Overall, BKAs had higher PLUS-M T-scores compared to AKAs and trauma etiologies had higher scores compared to DV. For AKAs, those with a MPK had higher T-scores compared to those with a nMPK. Results from this study provide average mobility for adult patients across every year of life. This can be leveraged to create a mobility adjustment factor to qualify good outcomes in lower limb prosthetic care.
ISSN:1464-5165
DOI:10.1080/09638288.2023.2208376