FUNCTIONAL RESTRICTION AND SATISFACTION WITH PROSTHESIS IN LOWER LIMB AMPUTEE PATIENTS

Year 2018, Volume: 32 Issue: 3, 213 - 218, 15.12.2018

Onur Engin Banu Dilek Hatice Merve Gökmen Ebru Şahin Ramazan Kızıl Ahmet Karakaşlı Özlem El

https://doi.org/10.5505/deutfd.2018.49469

Abstract

Objective: The aim of this study is to evaluate functional
restriction and satisfaction with prosthesis in lower limb amputee patients and
to determine the related factors.

Material
and Method:
 Forty three
lower limb amputee patients were recruited to study. Demographic and clinic
features of the patients were recorded. Groningen Activity Restriction Scale (GARS)
was used to evaluate the functional restriction of the patients. To determine
the patient satisfaction with prosthesis, Satisfaction with Prosthesis Questionnaire
was administered.

Results:  Mean age of the patiens was 43,2 ± 12,4 years. Twenty eight of the patients had below-knee, 12 had above knee amputation and 3 patients had knee dysarticulation. Twenty-one (48%) patients had K4, 19 (33%) patients had K3 functional level. Modular active vacuumed prosthesis for 28 patients, modular prothesis with microprocessor for 10 patients, hydrolic prosthesis for 5 patients has been prescribed. The baseline GARS median score was 21(18-64). Control GARS median score was 19 (18 – 60). The mean satisfaction with prothesis which is evaluated with Satisfaction with Prosthesis Questionnaire was %82.9 (min: 37, max: 100). There was no correlation between patients’ satisfaction with prosthesis or functional level with age and amputation level. Twenty eight patients who had modular prosthesis before and prescribed new modular prosthesis had significant improvement of functionality. Conclusion:  Prosthesis applications in lower extremity amputation decreases functional restriction and results in high patient satisfaction.

Keywords

amputation, prosthesis, patient satisfaction

Alt ekstremite ampüte hastalarda fonksiyonel kısıtlılık ve protez memnuniyeti

Abstract

Amaç: Bu çalışmanın amacı; alt ekstremite
ampute hastalarda fonksiyonel kısıtlılığı ve protez memnuniyetini
değerlendirmek ve ilişkili faktörleri ortaya koymaktır.

Gereç ve Yöntem: Çalışmaya alt
ekstremite ampütasyonu geçirmiş olan 43 hasta alındı. Hastaların demografik ve
klinik özellikleri kaydedildi. Hastaların fonksiyonel kısıtlılığını
değerlendirmek amacıyla Groningen Aktivite Kısıtlılık Skalası (GARS)
kullanıldı. Hasta memnuniyetini belirlemek için ise Protez Memnuniyet Anketi
uygulandı.

Bulgular: Hastaların yaş ortalaması 43,2 ± 12,4
idi. 28 hastanın diz altı, 12 hastanın diz üstü, 3 hastanın ise diz
dezartikülasyon seviyesinde ampütasyonu vardı. 21(%48) hastanın fonksiyonel seviyesi
K4, 19 (%44) hastanın fonksiyonel seviyesi K3’tü. Toplam 28 hastaya aktif
vakumlu, 10 hastaya mikroişlemcili, 5 hastaya hidrolik protez reçete edilmişti.
Hastaların başlangıç GARS medyan puanı 21 (18 – 64). Hastaların kontrol GARS
medyan puanı 19 (18 – 60) dur. Hastaların Protez Memnuniyet Anketi’ne göre
değerlendirilen memnuniyet ortalaması ise %82,9 (minimum: 37, maksimum: 100)
dur. Hastaların memnuniyetleri veya fonksiyonel düzeyleri ile yaş ve amputasyon
seviyesi arasında anlamlı ilişki saptanmadı. Daha önce modüler protez
kullanmakta olup yeni modüler protez reçete edilen 28 hastanın
fonksiyonelliğinde istatistiksel olarak anlamlı düzelme saptandı.

Sonuç: Alt ekstremite ampütasyonlarında
protez uygulamaları fonksiyonel kısıtlılığı azaltan ve hasta memnuniyetinin
yüksek olduğu uygulamalardır.

Keywords

ampütasyon, protez, hasta memnuniyeti

References

• Karami G, Ahmadi K, Nejati V, Masumi M. Better Mental Component of Quality of Life in Amputee. Iran J Public Health. 2012;41:53-58.
• Singh R, Hunter J, Philip A. The rapid resolution of depression and anxiety symptoms after lower limb amputation. Clin Rehabil. 2007;21:754–9.
• Gailey R, Allen K, Castles J, Kucharik J, Roeder M. Review of secondary physical conditions associated with lower-limb amputation and long-term prosthesis use. J Rehabil Res Dev. 2008;45:15-29.
• Dillingham TR, Pezzin LE, Mackenzie EJ. Limb amputation and limb deficiency: epidemiology and recent trends in the United States. South Med J. 2002; 95:875–83.
• Sauter CN, Pezzin LE, Dillingham TR. Functional Outcomes of Persons Undergoing Dysvascular Lower Extremity Amputations: Effect of a Post-Acute Rehabilitation Setting. Am J Phys Med Rehabil. 2013;92:287-96.
• MacKenzie EJ, Bosse MJ, Castillo RC. ve ark. Functional Outcomes Following Trauma-Related Lower-Extremity Amputation. J Bone Joint Surg Am. 2004;86:1636–645.
• Pinzur MS, Gottschalk FA, Pinto MA, Smith DG; American Academy of Orthopaedic Surgeons. Controversies in lower-extremity amputation. J Bone Joint Surg Am. 2007;89:1118-1127.
• Schürmann T, Beckerle P, Preller J, Vogt J, Christ O. Theoretical implementation of prior knowledge in the design of a multi-scale prosthesis satisfaction questionnaire. Biomed Eng Online. 2016;15(Suppl 3): 143.
• Kempen GI, Miedema I, Ormel J, Molenaar W. The assessment of disability with the Groningen Activity Restriction Scale. Conceptual framework and psychometric properties. Soc Sci Med. 1996;43:1601-10.
• Chamlian T, Melo A. Functional Assessment after lower limb amputation, Acta Fisiatr 2008;15:49 – 58.
• Bilodeau S, Hébert R, Desrosiers J. Questionnaire on the satisfaction of persons with lower-limb amputations towards their prosthesis: development and validation. Can J Occup Ther. 1999;66:23-32.
• Şimşek İE, Şener G, Yakut Y. Unilateral alt ekstremite amputelerinde Protez Memnuniyeti Anketi’nin Türkçe güvenirliği ve geçerliği: pilot çalışma. Fizyoter Rehabil. 2010;21:81-86.
• Saeed AB, Saeed UB, Zain-Ur-Rehman M, Ahmad Khan RD, Yasin A. Factors affecting functional outcome after lower extremity amputation. J Pak Med Assoc. 2015;65(11 Suppl 3):220-4.
• Pezzin LE, Dillingham TR, Mackenzie EJ, Ephraim P, Rossbach P. Use and satisfaction with prosthetic limb devices and related services. Arch Phys Med Rehabil. 2004;85:723-9.
• Akkaya N, Akkaya S, Şimşir Atalay N. Alt ekstremite ampute hastalarımızın demografik ve klinik özellikleri. Romatol Tıp Rehab. 2011;22:8-13.
• Waters RL, Perry J, Antonelli D, Hislop H. Energy cost of walking of amputees: the influence of level of amputation. J Bone Joint Surg Am. 1976;58:42–6.
• Penn-Barwell JG. Outcomes in lower limb amputation following trauma: A systematic review and meta-analysis. Injury. 2011;42:1474–9.
• Dillingham TR, Pezzin LE, MacKenzie EJ, Burgess AR. Use and satisfaction with prosthetic devices among persons with trauma-related amputations: a long-term outcome study Am J Phys Med Rehabil. 2001;80:563-71.
• Akarsu S, Tekin L, Safaz I Göktepe AS, Yazicioğlu K. Quality of life and functionality after lower limb amputations: comparison between uni- vs. bilateral amputee patients. Prosthet Orthot Int. 2013;37:9-13.
• Webster JB, Hakimi K, Williams RM, Turner AP, Norvell DC, Czerniecki JM. Prosthetic fitting, use, and satisfaction following lower-limb amputation. J Rehabil Res Dev. 2012;49:1493–1504.
• Schoppen T, Boonstra A, Groothoff JW, de Vries J, Göeken LN, Eisma WH.. Physical, mental, and social predictors of functional outcome in unilateral lower-limb amputees. Arch Phys Med Rehabil. 2003;84:803–811.
• Davie-Smith F, Paul L, Nicholls N, Stuart WP, Kennon B.. The impact of gender, level of amputation and diabetes on prosthetic fit rates following major lower extremity amputation. Prosthet Orthot Int. 2017;41: 19–25.