title: Prosthetic fitting, use, and satisfaction following lower-limb amputation: a prospective study.
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.
authors.affiliation: Department of Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA. joseph.webster@va.gov
authors.forename: Joseph B
authors.initials: JB
authors.lastname: Webster
authors.forename: Kevin N
authors.initials: KN
authors.lastname: Hakimi
authors.forename: Rhonda M
authors.initials: RM
authors.lastname: Williams
authors.forename: Aaron P
authors.initials: AP
authors.lastname: Turner
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Norvell
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Czerniecki
mesh_terms: D000368:Aged; D000673:Amputation, Traumatic / Q000534:rehabilitation*; D001186:Artificial Limbs; D003865:Major Depressive Disorder / Q000453:epidemiology; D005260:Female; D005684:Gait; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010549:Personal Satisfaction; D011446:Prospective Studies; D017755:Prosthesis Fitting; D012907:Smoking / Q000453:epidemiology; D012944:Social Support; D014945:Wound Healing / Q000502:physiology