Acta Scientific Orthopaedics (ISSN: 2581-8635)

Research Article Volume 6 Issue 5

Predicting Walking Ability and Prosthetic Candidacy Following Lower Extremity Amputation; An Updated Systematic Review and Treatment Pathway

Scott Love1*, Carolyn Dias-Karch1, Bianca Saragusti1, Rebekah Langreck1, Kayla Aponte1, Rebecca Miro2 and M Jason Highsmith3

1University of St. Augustine for Health Sciences, Doctor of Physical Therapy Program, St. Augustine FL
2University of South Florida, Morsani College of Medicine, School of Physical Therapy and Rehabilitation Sciences, Tampa, FL
3University of South Florida, Morsani College of Medicine, School of Physical Therapy and Rehabilitation Sciences, Tampa, FL. And U.S. Army Reserves. 319th Minimal Care Detachment. SP Corps. Pinellas Park, FL

*Corresponding Author: Scott Love, University of St. Augustine for Health Sciences, Doctor of Physical Therapy Program, St. Augustine FL.

Received: June 01, 2022; Published: April 13, 2023

Abstract

Background: There is not a clear compilation of existing literature that determines walking ability and prosthetic candidacy following lower extremity amputation (LEA). There is no multi-disciplinary instrument or patient centric decision-making protocol accepted that can predict walking ability and prosthetic candidacy nor support a treatment pathway. It is important to determine these factors to better assist clinicians in determining a patient’s MFCL K-level to assist with the delivery of proper prosthetic componentry. Medicare Functional Classification Level (MFCL) K-level is a 0 to 4-point scale of functional level for those with limb loss. The purpose of this systematic literature review is to further develop evidence-based LEA patient centric treatment pathways that determine prosthetic candidacy decisions for LEAs. This evidence will assist the healthcare team in the decision-making process. In a similar systematic review (SR), Kahle., et al. reported into 2016 on the prediction of walking ability following lower limb amputation (LLA).

Methods: This search strategy was designed and similarly implemented from the previous Kahle SR based on predicting walking ability. An electronic literature search was executed from 8/1/2007 to 12/31/2015 using MEDLINE, EMBASE, CINAHL, and Cochrane.

Results: After electronic search and a thorough review and elimination of articles, a total of 104 quality studies were identified. Of these, 78 were systematically reviewed in two previous reviews and eliminated. Twenty-six remained for full evaluation. These updated study conclusions are drawn from a total sample (n) of 46,651 subjects. The size of this updated study has increased the original Kahle., et al. report by including 300% more subjects for a combined total of 61,858 subjects in the two SRs.

Conclusion: In the two combined SRs, cause of amputation (etiology), physical fitness, pre-amputation living status, amputation level, age, physical fitness, cognitive/mood disturbances, social support and comorbidities are included as moderate to strongly supported predictive factors of walking ability and prosthetic candidacy. These factors should be strongly considered in a detailed history and physical examination by the rehabilitation team and documented in the patient healthcare record.

Keywords: Amputee; K-Level; Prosthesis; Rehabilitation; Functional Level; Prosthetic Candidacy; Treatment Pathway

References

  1. Sansam K., et al. “Predicting walking ability following lower limb amputation: a systematic review of the literature”. Journal of Rehabilitation Medicine8 (2009): 593-603.
  2. Ziegler-Graham K., et al. “Estimating the prevalence of limb loss in the United States: 2005 to 2050”. Archives of Physical Medicine and Rehabilitation 3 (2008): 422-429.
  3. Kahle JT., et al. “Alternate assessment tools or category systems-Candidacy for prosthetic technology”. American Orthotic and Prosthetic Association (2015).
  4. Kahle JT., et al. “Predicting walking ability following lower limb amputation: An updated systematic review. Technology and Innovation”. Journal of National Academy of Inventors 2-3 (2016): 125-137.
  5. Department of Health Long-term Conditions NSF Team. The National Service Framework for Long­term Conditions: Annex 2 Research and evidence. UK: Department of Health (2005): 88.
  6. Remes L., et al. “Predictors for institutionalization and prosthetic ambulation after major lower extremity amputation during an eight-year follow-up”. Aging Clinical and Experimental Research 2 (2009): 129-135.
  7. Henry AJ., et al. “Factors predicting resource utilization and survival after major amputation”. Journal of Vascular Surgery 3 (2013): 784-790.
  8. Miller WC., et al. “Lower extremity prosthetic mobility: a comparison of 3 self-report scales”. Archives of Physical Medicine and Rehabilitation 10 (2001): 1432-1440.
  9. Lim TS., et al. “Outcomes of a contemporary amputation series”. ANZ Journal of Surgery 5 (2006): 300-305.
  10. Pohjolainen T and Alaranta H. “Predictive factors of functional ability after lower-limb amputation”. Annales Chirurgiae et Gynaecologiae 1 (1991): 36-39.
  11. Taylor SM., et al. “Preoperative clinical factors predict postoperative functional outcomes after major lower limb amputation: an analysis of 553 consecutive patients”. Journal of Vascular Surgery2 (2005): 227-235.
  12. Amtmann D., et al. “Health-related profiles of people with lower limb loss”. Archives of Physical Medicine and Rehabilitation 8 (2015): 1474-1483.
  13. Sinha R and Van Den Heuvel WJA. “A systematic literature review of quality-of-life lower limb amputees”. Disability and Rehabilitation11 (2011): 883-899.
  14. Melchiorre PJ., et al. “Functional outcome and comorbidity indexes in the rehabilitation of the traumatic versus the vascular unilateral lower limb amputee”. American Journal of Physical Medicine and Rehabilitation1 (1996): 9-14.
  15. Durmus D., et al. “The relationship between prosthesis use, phantom pain and psychiatric symptoms in male traumatic limb amputees”. Comprehensive Psychiatry 59 (2015): 45-53.
  16. Osmani-Vllasolli T., et al. “Rehabilitation of patients with war-related lower limb amputations”. Nigerian Journal of Medicine 1 (2011): 39-43.
  17. Cooper R., et al. “Age and gender differences in physical capability levels from mid-life onwards: the harmonization and meta-analysis of data from eight UK cohort studies”. PLoS One11 (2011).
  18. Arneja AS., et al. “Functional Outcomes of Patients with Amputation Receiving Chronic Dialysis for End-Stage Renal Disease. American Journal of Physical Medicine and Rehabilitation4 (2015).
  19. Van Velzen JM., et al. “Physical capacity and walking ability after lower limb amputation: a systematic review”. Clinical Rehabilitation 11 (2006): 999-1016.
  20. Demet K., et al. “Health related quality of life and related factors in 539 persons with amputation of upper and lower limb”. Disability and Rehabilitation9 (2003): 480-486.
  21. Vogel TR., et al. “Impact of amputation level and comorbidities on functional status of nursing home residents after lower extremity amputation”. Journal of Vascular Surgery 5 (2014): 1323-1330.
  22. Langlois K., et al. “Influence of physical capacities of males with transtibial amputation on gait adjustments on sloped surfaces”. Journal of Rehabilitation Research and Development 2 (2014): 193-200.
  23. Nadollek H., et al. “Outcomes after trans-tibial amputation: the relationship between quiet stance ability, strength of hip abductor muscles and gait”. Physiotherapy Research International4 (2002): 203-214.

Citation

Citation: Scott Love., et al. “Predicting Walking Ability and Prosthetic Candidacy Following Lower Extremity Amputation; An Updated Systematic Review and Treatment Pathway”.Acta Scientific Orthopaedics 6.5 (2023): 56-71.

Copyright

Copyright: © 2023 Scott Love., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




Metrics

Acceptance rate33%
Acceptance to publication20-30 days

Indexed In



News and Events


  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is November 25, 2024.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of "Best Article of the Issue"
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.

Contact US