Weight-bearing, pain and walking velocity during primary transtibial amputee rehabilitation.
OBJECTIVE
To explore the relationships between weight-bearing, pain and walking velocity in the first four weeks of prosthetic training.


METHODS
Consecutively referred transtibial amputees (n = 27).


METHODS
Longitudinal study.


METHODS
Inpatient rehabilitation centre.


METHODS
Measurements of static weight-bearing (SWB), perceived pain during the SWB test and self-selected walking velocity (VEL) were taken at entry, and at four weeks into the prosthetic training programme. Path analysis was conducted using a series of linear regression analyses to determine predictors of walking velocity at week 4.


RESULTS
Significant improvements from week 1 to week 4 were found in SWB, reported pain and velocity. SWB at week 4, when coupled with age, predicted 66% of the variance in walking velocity at week 4. Pain did not directly predict velocity. However, SWB at entry and perceived pain at week 4 predicted 56% of the variance in SWB at week 4.


CONCLUSIONS
These analyses suggested a model in which SWB and age were both significantly related to velocity, and further, that pain played a role in velocity through a relationship mediated by its direct effect on SWB. Unlike age, SWB is a predictor of velocity that might be altered through pain reduction, wound-healing and rehabilitative interventions.
Jones
M E
ME
Illawarra Area Health Service, Port Kembla Hospital, Warrawong, NSW, Australia. jonesm@iahs.nsw.gov.au
Bashford
G M
GM
Bliokas
V V
VV
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000009:adverse effects* / Q000534:rehabilitation*; D000674:Amputees / Q000534:rehabilitation*; D000704:Analysis of Variance; D001186:Artificial Limbs / Q000009:adverse effects*; D005260:Female; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D011237:Predictive Value of Tests; D012307:Risk Factors; D013977:Tibia / Q000601:surgery*; D013997:Time Factors; D016138:Walking; D016474:Weight-Bearing; D014945:Wound Healing