Effect of Socioeconomic and Health Factors on Prosthetic Use after Lower-Limb Amputation

Abstract

The aim of this study was to determine predictors of functional prosthetic use after transtibial or transfemoral amputation. In 52 patients (41 [79%] men; 39 [75%] diabetic patients; mean [SD] age, 59 [14] years; mean [SD] body mass index, 29 [5] kg/m2) who had transtibial (43 limbs) or transfemoral (10 limbs) amputation, most frequently for peripheral vascular disease (44 [85%] patients), an in-person or telephone survey was done 2 years after prosthetic fitting and completion of rehabilitation. Functional prosthetic use (Houghton Scale) was significantly associated with younger patient age, higher household income, greater level of ambulation (K-level) at discharge from rehabilitation, fewer medical comorbidities, and patient satisfaction with prosthetist and cosmetic appearance. Activity level with prosthesis (Locomotor Capabilities Index) was significantly associated with younger patient age, higher level of completed education, greater level of ambulation (K-level) at discharge from rehabilitation, fewer medical comorbidities, and patient satisfaction with prosthetist and prosthetic fit. There was no effect of ethnicity, community of residence, amputation level, living arrangement, premorbid dwelling, or specific comorbidities on frequency of prosthetic use, functional prosthetic use (Houghton Scale), or activity level (Locomotor Capabilities Index). Several factors, including level of ambulation upon completion of rehabilitation, may predict functional prosthetic outcome after lower-limb amputation.