Prosthetic fitting, use, and satisfaction following lower-limb amputation: A prospective study

• Published in: Journal of rehabilitation research and development Vol. 49; no. 10; p. 1493
• Main Authors: Webster, Joseph B., Hakimi, Kevin N., Williams, Rhonda M., Turner, Aaron P., Norvell, Daniel C., Czerniecki, Joseph M.
• Format: Journal Article
• Language: English
• Published: United States Superintendent of Documents 01.01.2012
• Subjects: Aged; Amputation; Amputation, Traumatic - rehabilitation; Artificial Limbs; Depressive Disorder, Major - epidemiology; Female; Gait; Health care; Humans; Male; Middle Aged; Multivariate Analysis; Personal Satisfaction; Prospective Studies; Prostheses; Prosthesis Fitting; Smoking - epidemiology; Social Support; Studies; Wound Healing - physiology
• ISSN: 0748-7711; 1938-1352; 1938-1352
• DOI: 10.1682/JRRD.2012.01.0001

Providing a satisfactory, functional prosthesis following lower-limb amputation is a primary goal of rehabilitation. The objectives of this study were to describe the rate of successful prosthetic fitting over a 12 mo period; describe prosthetic use after amputation; and determine factors associated with greater prosthetic fitting, function, and satisfaction. The study design was a multicenter prospective cohort study of individuals undergoing their first major lower-limb amputation because of vascular disease and/or diabetes. At 4 mo, unsuccessful prosthetic fitting was significantly associated with depression, prior arterial reconstruction, diabetes, and pain in the residual limb. At 12 mo, 92% of all subjects were fit with a prosthetic limb and individuals with transfemoral amputation were significantly less likely to have a prosthesis fit. Age older than 55 yr, diagnosis of a major depressive episode, and history of renal dialysis were associated with fewer hours of prosthetic walking. Subjects who were older, had experienced a major depressive episode, and/or were diagnosed with chronic obstructive pulmonary disease had greater functional restriction. Thus, while most individuals achieve successful prosthetic fitting by 1 yr following a first major nontraumatic lower-limb amputation, a number of medical variables and psychosocial factors are associated with prosthetic fitting, utilization, and function.