Lower limb amputation is a common clinical problem with around 7,000 leg amputations occurring in the UK per year. This commonly results in impaired mobility, which may also influence an individual's quality of life and independence. However, it is difficult to predict walking ability with a prosthesis accurately. The objective of this thesis is to establish whether simple clinical tests can be used to predict walking outcome following lower limb amputation . A systematic literature review, performed to establish current knowledge regarding predictors of walking following lower limb amputation, found inconsistent results and variability in methodology making comparison difficult. Data were collected to ascertain the current clinical assessment practice and mobility outcome for lower limb amputees in Leeds. This indicated that only around one third of patients achieve independent walking with a prosthesis. A qualitative interview study was completed with clinicians experienced in amputee rehabilitation to explore in more depth the decision making processes that are used to determine whether a patient is supplied with a prosthesis and what components are prescribed. This identified four key themes, one of which was estimating outcome, emphasising the clinical importance of predicting walking outcome in amputee rehabilitation. The final section of the research took the form of an observational study looking at the predictive nature of simple clinical tests on walking outcome after prosthetic rehabilitation. Backward stepwise multiple linear regression analysis resulted in a model that was able to predict 59% of the variance in the timed up and go test and contained six predictor variables; age, gender, amputation level, presence of contracture, ability to stand on one leg and performance on the trail making test. If confirmed in a larger population and across multiple sites these simple tests could be used to improve estimation of walking outcome in the future.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:659125 |
| Date | January 2011 |
| Creators | Sansam, Katherine Alice Julia |
| Publisher | University of Leeds |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
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