Article

In people with lower-limb amputation and hemiparesis, prognostic factors
of rehabilitation outcomes were investigated at hospital discharge. This study
aims to identify which factors influence functional outcomes at mid- to long-term
follow-up. METHODS: Follow-up observational study on forty-four people (68 +/- 9
years old) with unilateral amputation for vascular disease, temporally preceding
or following hemiparesis due to stroke (26 patients prior amputation; 18 patients
prior stroke), was performed. Barthel Index (BI) and Locomotor Capabilities Index
(LCI) scores were recorded at discharge from the rehabilitation hospital and 3.4
years later. Use of the prosthesis was also recorded. RESULTS:
At the follow-up,
BI and LCI scores had significantly decreased (10 and 13%, respectively).
Contralaterality of the impairment was the main prognostic factor for reduced
functional status (p = 0.025)
and prosthesis abandonment
(p = 0.028, OR = 4.4),
especially for women (OR = 8). Severity of hemiparesis affected the BI score (p <
0.01) and level of amputation the LCI score (p < 0.01). CONCLUSIONS: At the light
of the observed decrement of functional status after discharge, particular
attention should be paid to the patients more exposed to the risk of worsening
and/or prosthesis abandon, such as women with contralateral impairment. The
results of this study may assist rehabilitation teams in performing a more specific and effective long-term rehabilitative interventions.

Langue : ANGLAIS