title: Barriers to outcome measure administration and completion at discharge from inpatient rehabilitation of people with amputation.
abstract: We performed a retrospective chart review of consecutive patients discharged from an inpatient amputee rehabilitation program over a 2 yr period (January 2010-December 2011). Our objective was to determine barriers to the completion of a standardized maximum walk test (MWT) at discharge. Over the study period, there were 190 discharges. The sample had a mean age of 63.5 yr (standard deviation [SD] +/- 14.2 yr), was 71.6% male, and had a majority of transtibial amputation (67%). The average length of inpatient stay was 28.1 d (SD +/- 13.2 d). MWT including distance and time was completed in 149 (78%) of the discharges; the main factors limiting patient performance on this measure were cardiorespiratory fatigue (53%), lower-limb pain (24%), back pain (12%), and skin problems (6%). Among those patients who completed the MWT, in 31% no limiting factor was identified. Forty-one discharge MWTs were not completed as a result of nonambulatory status (34%), acute illness (17%), limb pain (7%), skin problems (12%), or other reasons. Knowing these limitations may direct care from a clinical standpoint and provides valuable data for research planning to further examine outcome measures in this population.
authors.affiliation: Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada; and Department of Physical Medicine and Rehabilitation, Parkwood Institute, St. Joseph's Health Care London, London, Ontario, Canada.
authors.forename: Heather M
authors.initials: HM
authors.lastname: MacKenzie
authors.affiliation: Lawson Health Research Institute, London, Ontario, Canada.
authors.forename: Danielle B
authors.initials: DB
authors.lastname: Rice
authors.affiliation: Parkwood Institute, St. Joseph's Health Care London, London, Ontario, Canada.
authors.forename: C Michele
authors.initials: CM
authors.lastname: Sealy
authors.affiliation: Parkwood Institute, St. Joseph's Health Care London, London, Ontario, Canada.
authors.forename: Peter D
authors.initials: PD
authors.lastname: Cox
authors.affiliation: Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada; and Department of Physical Medicine and Rehabilitation, Parkwood Institute, St. Joseph's Health Care London, London, Ontario, Canada.
authors.forename: A Barry
authors.initials: AB
authors.lastname: Deathe
authors.affiliation: Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada; and Department of Physical Medicine and Rehabilitation, Parkwood Institute, St. Joseph's Health Care London, London, Ontario, Canada.
authors.forename: Michael W C
authors.initials: MW
authors.lastname: Payne
mesh_terms: D000368:Aged; D000671:Amputation, Surgical / Q000534:rehabilitation*; D000674:Amputees; D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010351:Patient Discharge; D012189:Retrospective Studies; D016896:Treatment Outcome; D000070857:Walk Test
keywords: amputees; diabetes; gait; locomotion; lower-limb amputation; outcome measures; peripheral vascular disease; rehabilitation; rehabilitation center; walk test