title: Physical disability after severe lower-extremity injury.
abstract: OBJECTIVE
  To investigate the use of a combined measure of decreased walking speed and gait deviation to identify high physical disability in patients with lower-limb salvage.
  
  
  METHODS
  Longitudinal study of patients with severe lower-extremity trauma.
  
  
  METHODS
  Eight level I trauma centers.
  
  
  METHODS
  Patients (N=276) with lower-limb salvage from the Lower Extremity Assessment Project.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Disability from the physical dimension of the Sickness Impact Profile (SIP), walking speed, and gait deviation were measured at 24 months of follow-up. A 1-way analysis of variance and planned comparisons compared mean SIP scores across and between the following 3 outcome groups: no impaired speed and no gait deviation, impaired speed or gait deviation, and impaired speed and gait deviation.
  
  
  RESULTS
  Mean SIP scores for the physical dimension and its 2 categories of ambulation and body care and movement differed statistically across the planned comparisons. The mobility category showed that the impaired speed or deviation group was statistically similar to the group without impaired speed and gait deviation.
  
  
  CONCLUSIONS
  The combination of decreased walking speed and gait deviation appears to provide a valid measure of physical disability among patients with lower-limb salvage.
authors.affiliation: Center for Injury Research and Policy, Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA. karcher5@comcast.net.
authors.forename: Kristin R
authors.initials: KR
authors.lastname: Archer
authors.forename: Renan C
authors.initials: RC
authors.lastname: Castillo
authors.forename: Ellen J
authors.initials: EJ
authors.lastname: Mackenzie
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Bosse
mesh_terms: D000704:Analysis of Variance; D004185:Disability Evaluation; D005260:Female; D005684:Gait / Q000502:physiology; D006801:Humans; D007869:Leg Injuries / Q000503:physiopathology* / Q000534:rehabilitation; D008137:Longitudinal Studies; D008297:Male; D018434:Sickness Impact Profile; D016138:Walking / Q000502:physiology