Functional independence in the lower limb amputees - The effect of gender and amputation level

Abstract

Introduction/Background The Functional Independence Measure (FIM) instrument is widely used in the clinical practice, but merely in the lower limb amputees and without differentiation between men and women as well as between transtibial (TT) and transfemoral (TF) amputees. Only the total FIM score and/or motor FIM and cognitive FIM subscores are analyzed, in spite that certain parts of motor FIM score attract more interest of practitioners. The aim of this study was to confirm the hypothesis of better functional abilities in the amputee men than women and in TT than TF. We wanted to demonstrate the advantage of a detailed analysis of the motor FIM too. Material and method Two hundred and twenty-nine hospitalization cases of the lower limb amputees were sorted into eight groups according to their gender and amputation level (TT or TF), separately for the first and second hospitalization. The scores of motor FIM, walk, stair climbing, self-care and transfers at the admission and discharge were chosen as variables as well as the age, length of stay (LOS) and the interval between the surgery and admission to rehabilitation department (delay). The Mann–Whitney test was used to set the significant differences at the level P Results The gender effect on functional independence was ascertained in almost all motor FIM parts, especially at the first discharge and second admission. Amputation level effect was also ascertained frequently at discharge, especially in walk and stair climbing. The effect of age, LOS or delay was very rare. Conclusion Expected better functional abilities in men and TT were confirmed. The analysis of selected parts of motor FIM brings more detailed information than the Total FIM exclusively.