Article

Returning wounded veterans and servicemembers to their highest level of function
following traumatic injury is a priority of the Departments of Defense and
Veterans Affairs. We surveyed 245 veterans from the Vietnam war and 226
servicemembers and veterans from Operation Iraqi Freedom/Operation Enduring
Freedom (OIF/OEF) conflicts with at least one major traumatic lower-limb loss to
determine their use of mobility assistive technology (AT) and patterns of limb
abandonment. Prosthetic device use without wheelchair use is found in 50.5% of
Vietnam and 42.8% of OIF/OEF groups. Prostheses and supplementary wheelchairs are
used by Vietnam (32%) and OIF/OEF (53%) groups (p < 0.01). Exclusive wheelchair
use is more frequent in the Vietnam group (18%) than in the OIF/OEF group (4.0%,
p < 0.01). In Vietnam participants, multivariate analysis found that
multiple-limb loss (adjusted odds ratio [AOR] = 14.5; 95% confidence interval
[CI] 5.5-38.5), bilateral lower-limb loss (AOR = 12.7; 95% CI 6.2-26.1), and
number of comorbidities (AOR = 1.3; 95% CI 1.2-1.5) are associated with increased
likelihood of wheelchair use. In OIF/OEF participants, bilateral lower-limb loss
(AOR = 29.8; 95% CI 11.0-80.7), multiple-limb loss (AOR = 16.3; 95% CI 3.1-85.3),
cumulative trauma disorder (AOR = 2.4; 95% CI 1.2-4.9), and number of combat
injuries (AOR = 1.4; 95% CI 1.2-1.7) are associated with wheelchair use. Combined
use of different types of mobility ATs promotes improved rehabilitation and ability to function.

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