An analysis of functional outcome for a group of older lower limb amputees after in-patient hospitalisation

Abstract

Aim: To measure the degree of functional change experienced by older lower limb amputees at discharge from in-patient hospitalisation. To analyse this change in view of potential physical and psychosocial determinants of functional outcome. Method: Twenty-five, newly operated, older lower limb amputees were identified and assessed twice. Their pre-operative and post-operative functional ability was measured. Information was also gathered regarding a diverse range of potential determinants of outcome. Results: The absolute majority of the studied amputees experienced diminished functional ability at discharge from in-patient hospitalisation. This was experienced even in areas which they identified as being their own preferred goals. A statistically significant association was demonstrated with some determinants. Conclusion: Functional outcome is indeed the result of the inter-action between a number of physical and psychosocial determinants. Some aspects of current practice which could influence the older persons' ability to learn new skills in meeting functional needs could be addressed. Acknowledging the impact of psychological adjustment to limb loss and providing the necessary support might liberate energy and resources that the older person could invest in the rehabilitation process. This might result in better functional outcomes.