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

J Rehabil Res Dev. 2012;49(10):1493-504. doi: 10.1682/jrrd.2012.01.0001.

Abstract

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.

Publication types

  • Multicenter Study
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Amputation, Traumatic / rehabilitation*
  • Artificial Limbs*
  • Depressive Disorder, Major / epidemiology
  • Female
  • Gait
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Personal Satisfaction*
  • Prospective Studies
  • Prosthesis Fitting*
  • Smoking / epidemiology
  • Social Support
  • Wound Healing / physiology