The Effect of Advanced Age on Prosthetic Rehabilitation Functional Outcomes in People With Lower Limb Amputations: A Retrospective Chart Audit of Inpatient Admissions

Abstract

Objective: To evaluate the effect of age on functional outcomes at discharge from prosthetic rehabilitation.Design: Retrospective chart audit.Setting: Rehabilitation hospital.Participants: Individuals ≥50 years with a transtibial level lower limb amputation (LLA) and above admitted to the inpatient prosthetic rehabilitation program from 2012 to 2019 (n=504). A secondary analysis included a subset of matched participants (n=156).Interventions: Not applicable.Main Outcome Measures: The L-Test of Functional Mobility (L-Test), 2-Minute Walk Test (2MWT), 6-Minute Walk Test (6MWT), and Activities-specific Balance Confidence scale.Results: A total of 504 participants (66.7±10.1 years) met the inclusion criteria, 63 participants (84.9±3.7 years) were part of the oldest old group. The sample was stratified into 4 age groups (50-59, 60-69, 70-79, and 80+) for data analysis. The analysis of variances were statistically significant for all outcome measures (P<.001). Post-hoc testing for the L-Test, 2MWT, and 6MWT demonstrated that the oldest old had significantly reduced performance compared with people 50-59 years old (P<.05), but there were no significant differences between the oldest old and the 60-69 [(L-Test, P=.802), (2MWT, P=.570), (6MWT, P=.772)] and 70-79 [(L-Test, P=.148), (2MWT, P=.338), (6MWT, P=.300)] age groups. The oldest old reported significantly lower balance confidence compared with all 3 age groups (P<.05).Conclusion: The oldest old achieved similar functional mobility outcomes as people 60-79 years, the most common age group of people with an LLA. Advanced age alone should not disqualify individuals from prosthetic rehabilitation.