Influencing factors and ambulation outcome in patients with dual disabilities of hemiplegia and amputation.
OBJECTIVE
To determine the ambulatory outcome and predictive factors of successful ambulation training in patients with both hemiplegia and lower extremity amputation.


METHODS
A retrospective study.


METHODS
A rehabilitation center of a university hospital.


METHODS
Twenty-three patients with dual disabilities consecutively admitted to the rehabilitation center from 1984 to 1994.


METHODS
Ambulatory outcome was measured using physical therapists' and physicians' notes at discharge or the last available clinical visit. Ambulation ability was graded as community and noncommunity ambulation, which included indoor ambulation and nonambulation. Several clinical features were reviewed to assess their association with ambulation outcome.


RESULTS
About two thirds of the 23 patients could be trained to be ambulatory: 10 (43.8%) achieved community ambulation and 5 (21.7%) achieved indoor ambulation. Of the clinical factors, only mental status showed a statistically significant association with good ambulation outcome (p<.05). When odds ratios were considered, several factors, including mild motor involvement, transtibial amputation, amputation before cerebrovascular accident, age younger than 60 years, and the presence of ipsilateral hemiplegia and amputation, showed trends toward association with increased ambulation achievement, although these associations were not statistically significant.


CONCLUSIONS
Impaired mental status seemed to be the most influential negative predictive factor of achieving community ambulation. If subjects with dual disabilities are properly selected, satisfactory results of ambulation training will be obtained.
Chiu
C C
CC
Department of Physical Medicine and Rehabilitation, National Taiwan University hospital, Taipei, ROC.
Chen
C E
CE
Wang
T G
TG
Lin
M C
MC
Lien
I N
IN
D000368:Aged; D000369:Aged, 80 and over; D000674:Amputees / Q000534:rehabilitation*; D001927:Brain Diseases; D005260:Female; D006429:Hemiplegia / Q000145:classification / Q000150:complications / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012047:Rehabilitation Centers; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D016138:Walking