Body mass index patterns following dysvascular lower extremity amputation

Disabil Rehabil. 2013 Jul;35(15):1269-75. doi: 10.3109/09638288.2012.726690. Epub 2012 Oct 25.

Abstract

Purpose: Using preliminary data, we examined: (i) patterns of body mass index (BMI) over the year following amputation by amputation level and (ii) the association between BMI and mobility and prosthetic device use.

Method: Patients from three medical centers undergoing dysvascular amputation (N = 87; M age = 62) participated in interviews pre-surgically and at 6 weeks, 4 months, and 12 months following amputation. The main outcome was self-reported BMI, adjusting for limb weight lost due to amputation. Additional outcomes were mobility and time spent using and walking in a prosthetic device.

Results: Adjusted BMI slightly decreased at 6 weeks (pre-surgery M = 31.2; 6 weeks M = 30.3) and 4 months (M = 30.7) but exceeded baseline levels by 12 months (M = 31.7). There were no significant BMI differences by amputation level. In multivariable analyses, higher pre-surgical BMI was associated with fewer hours of prosthetic device walking at month 4 (β = -0.49) and poorer overall mobility at month 12 (β = -0.22).

Conclusions: BMI increased at one year following amputation surgery. Higher pre-surgical BMI was associated with poorer mobility and prosthetic device use. Interventions are needed to prevent excess weight gain in the year following amputation.

Implications for rehabilitation: • People undergoing lower-extremity amputation have high rates of overweight and obesity and continue to gain weight in the year following amputation. • Objective assessment of body mass index (both with and without a prosthetic device) and waist circumference would help future research efforts. • Targeting weight loss post-amputation could improve the health of people with lower-extremity amputations.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Aged
  • Amputation, Surgical / rehabilitation*
  • Body Mass Index*
  • Female
  • Follow-Up Studies
  • Humans
  • Interviews as Topic
  • Lower Extremity / surgery
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care
  • Time Factors
  • Vascular Diseases / surgery
  • Walking*
  • Weight Gain