title: Functional and Mental Health Status of United Kingdom Military Amputees Postrehabilitation.
abstract: OBJECTIVE
  To evaluate the functional and mental health status of severely injured traumatic amputees from the United Kingdom military at the completion of their rehabilitation pathway and to compare these data with the published normative data.
  
  
  METHODS
  Retrospective independent group comparison of descriptive rehabilitation data recorded postrehabilitation.
  
  
  METHODS
  A military complex trauma rehabilitation center.
  
  
  METHODS
  Amputees (N=65; mean age, 29±6 y) were evaluated at the completion of their rehabilitation pathway; of these, 54 were operationally (combat) injured (23 unilateral, 23 bilateral, 8 triple) and 11 nonoperationally injured (all unilateral).
  
  
  METHODS
  Continuous ∼4-week inpatient, physician-led, interdisciplinary rehabilitation followed by ∼4-weeks of patient-led, home-based rehabilitation.
  
  
  METHODS
  The New Injury Severity Score at the point of injury was used as the baseline reference. The 6-minute walk test, Amputee Mobility Predictor with Prosthesis, Special Interest Group in Amputee Medicine, Defence Medical Rehabilitation Centre mobility and activity of daily living scores as well as depression (Patient Health Questionnaire-9), anxiety (General Anxiety Disorder Scale-7), mental health support, and pain scores were recorded at discharge and compared with the published normative data.
  
  
  RESULTS
  The mean New Injury Severity Score was 40±15. After 34±14 months of rehabilitation, amputees achieved a mean 6-minute walk distance of 489±117 m compared with age-matched normative distances of 459 to 738 m. The 2 unilateral groups walked (544 m) significantly further (P>.05) than did the bilateral amputee (445±104 m) and triple amputee (387±99 m) groups. All groups demonstrated mean functional mobility scores consistent with scores of either active adults or community ambulators with limb loss. In total, 85% could walk/run independently and 95% could walk and perform activities of daily living independently with an aid/adaptation. No significant difference in mental health outcome was reported between the groups (P>.05). At discharge, 98% of patients were able to control their pain.
  
  
  CONCLUSIONS
  Severely injured military amputees who completed intensive interdisciplinary rehabilitation achieved levels of physical function comparable with those in age-matched healthy adults. Mental health outcomes were indicative of preparedness for full integration back into society.
authors.affiliation: Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre (DMRC) Headley Court, Headley, Epsom, Surrey, UK; Department for Health, University of Bath, Bath, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Ladlow
authors.affiliation: Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre (DMRC) Headley Court, Headley, Epsom, Surrey, UK.
authors.forename: Rhodri
authors.initials: R
authors.lastname: Phillip
authors.affiliation: Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre (DMRC) Headley Court, Headley, Epsom, Surrey, UK.
authors.forename: John
authors.initials: J
authors.lastname: Etherington
authors.affiliation: Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre (DMRC) Headley Court, Headley, Epsom, Surrey, UK.
authors.forename: Russell
authors.initials: R
authors.lastname: Coppack
authors.affiliation: Department for Health, University of Bath, Bath, UK.
authors.forename: James
authors.initials: J
authors.lastname: Bilzon
authors.affiliation: Department for Health, University of Bath, Bath, UK.
authors.forename: M Polly
authors.initials: MP
authors.lastname: McGuigan
authors.affiliation: Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre (DMRC) Headley Court, Headley, Epsom, Surrey, UK. Electronic address: alexander.n.bennett@btinternet.com.
authors.forename: Alexander N
authors.initials: AN
authors.lastname: Bennett
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000674:Amputees / Q000523:psychology* / Q000534:rehabilitation*; D005260:Female; D006304:Health Status; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008603:Mental Health; D008889:Military Personnel / Q000523:psychology*; D010146:Pain / Q000523:psychology / Q000534:rehabilitation; D012047:Rehabilitation Centers; D012189:Retrospective Studies; D006113:United Kingdom
keywords: Amputees; Mental health; Outcome assessment (health care); Physical and rehabilitation medicine; Rehabilitation