A Demographic Study of Lower Limb Amputees in a North Indian Tertiary Rehabilitation Center (original) (raw)
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Disability and Rehabilitation, 2019
Objective: We aimed to describe the causes, types, and consequences of lower limb amputation and the demographics of subjects with such amputation who attended a tertiary rehabilitation center in Bangladesh, Centre for the Rehabilitation of the Paralysed. Methods: Cross-sectional data were collected from subjects with lower limb amputation who attended a specialized rehabilitation center between January 2014 and August 2016. Telephone interviews were conducted using a structured questionnaire. Descriptive analysis, paired t-test, and Fisher's exact test were conducted as well as a regression analysis was performed. Results: A total of 332 respondents, aged 5 to 76 years (mean 37.5± SD 13.8), with lower limb amputation participated in the study. Of the respondents, the majority were male (87.7%) and lived in rural areas (64.8%). Road traffic accidents were the leading cause (58.7%) of amputation followed by peripheral vascular diseases (7.5%) and hit by sharp objects (7.2%). Age (odds ratio: 0.9) and driving as occupation (odds ratio: 7.3) were found to be statistically significant covariates for amputation from road traffic accidents. The mean duration between having an amputation and receiving the first prosthetic fitting was 6.4 years (±8.9). Among the study participants, 30.7% lost their jobs after amputation and their mean monthly income reduced significantly (p < 0.01) from US$119.9 (±421.5) to US$45.8 (±63.1). Conclusion: Majority of the lower limb amputations resulted from traumatic road traffic accidents. Younger males and drivers were found to be more prone to amputation from road traffic accidents. Lower limb amputation creates great health and economic disparity in the amputee's lives. ä IMPLICATIONS FOR REHABILITATION Majority of the lower limb amputation cases in Bangladesh were attributable to road traffic accidents-a largely preventable cause. The mean time between amputation and prosthetic fitting was more than 6 years which implies lack of awareness and inaccessibility of prosthetic management. Policymakers, regulators, law enforcement, and traffic safety advocates should take urgent actions to prevent road traffic accidents and raise awareness about and improve availability of prosthetic rehabilitation in Bangladesh.
Global trends in incidence of lower limb amputation: a review of the literature
South African Journal of Physiotherapy, 2008
The aim of this paper was to compile a literature report on the global epidemiology of lower limb amputations. Specifically it aimed at capturing information on the incidence of traumatic and non-traumatic lowerlimb amputations throughout the world, to identify the etiology including diseases and lifestyle habits associated with lower limb amputees (LLA) in boththe developed and the developing countries, to identify the demographiccharacteristics, age, sex, race, geographical location of the people undergoing LLA including the levels of amputation as pointed out by the literature. Aliterature search was conducted. Different keyword combinations were used togather as much literature on the subject as possible. The authors systemicallyreviewed literature from some parts of Europe, Asia, North and South America and South Africa. The data was analyzed and presented under various themes. The existing literature shows that diabetes is the leading cause of LLA and trauma accounts for the m...
Global prevalence of traumatic non-fatal limb amputation
Prosthetics & Orthotics International, 2020
Background Limb amputation impairs physical functioning and mobility of people around the world. Leading causes of limb amputation have been reported to vary depending on region. Peripheral vascular disease and diabetes are commonly identified as the leading causes of limb amputation in highincome countries (HICs). 1-3 However, in many low-and middle-income countries (LMICs), trauma has been documented as the primary mechanism for limb amputation. 4-6 Trauma, and resultant limb amputation, has also been identified as a largely neglected epidemic in LMICs, warranting increased focus on both prevention and treatment. 7-9 To improve prosthetic rehabilitation for people with limb amputation, the World Health Organization (WHO) published new prosthetic and orthotic (P&O) service provision standards in 2017. 10 These guidelines highlight four
Physical therapy, 2020
Background. Despite the prevalence of lower limb amputation (LLA), only a small percentage of people with LLA actually receive physical therapy post amputation and are rehabilitated to their full potential level of function. There is a need for the development of a rehabilitation program that targets impairments and limitations specific to people with LLA. Objective. The objective of this study was to determine whether the Evidence-Based Amputee Rehabilitation program would improve functional mobility of people with unilateral transtibial amputation (TTA) who have already completed physical therapy and prosthetic training. Design. This study was a randomized, wait-list control, single-blinded pilot clinical trial. Setting. This study researched participants who had received postamputation rehabilitation to varying degrees, either in an inpatient and/or outpatient settings. Participants. The participants in this study included veterans and nonveterans with unilateral TTA due to dysvascular disease and trauma. Intervention. This study included a prescription-based rehabilitation program for people with amputations. Measurements. Results were measured with The Amputee Mobility Predictor with (AMPPro) and without a prosthesis (AMPnoPro) and 6-Minute Walk Test (6MWT) at baseline and at the end of the 8-week intervention. Results. The intervention group improved on the AMPPro scores (36.4 to 41.7), AMPnoro scores (23.2 to 27.1), and 6MWT distance (313.6 to 387.7 m). The effect size for the intervention was very large (1.32). In contrast, the wait-list control group demonstrated no change in AMPPro scores (35.3 to 35.6), AMPnoPro scores (24.7 to 25.0), and 6MWT distance (262.6 m to 268.8 m). Limitations. The sample size was small. A total 326 potential candidates were screened with 306 unable to meet inclusion criteria or unwilling to participate. Conclusion. People with unilateral TTA who received Evidence-Based Amputee Rehabilitation program demonstrated significant improvement in functional mobility, with most participants (66.7%) improved at least 1 K-level (58.3%) and greater than the minimal detectable change (66.7%).
Clinical and demographic characteristics of patients with lower limb amputation
Ege Tıp Dergisi, 2019
Aim: Lower limb loss affects an individual’s ability to stand, transfer, and ambulate. The aim of this study is to assess clinical and demographic characteristics of patients with lower limb amputation.Materials and Methods: Our study is a retrospective cohort study. 836 patients with lower limb amputation applied to our hospital between January 2012 and May 2013 were included in this study. Demographic and clinical characteristics of patients were reviewed and saved from patient’s folder. Descriptive variables were shown as mean±standard deviation(min–max). And categorical variables were shown as the number of cases (n%).SPSS software Version 15.0 was used in the evaluation of the data.Results: The mean age of total 836 lower limb amputees was 36.12±11.69 years (9-78). The percentage of unilateral amputation was 770(92.3%) and bilateral lower limb amputation was 59(7.1%). According to the level of amputation, 456(54.5%) of the patients had unilateral above-knee, 236(28.3%) had unil...
Pattern of Limb Amputations in Male Patients in a Nigerian Teaching Hospital
IOSR Journal of Dental and Medical Sciences, 2014
Introduction: Most amputation surgeries worldwide are carried out in male patients. This negatively affects the socioeconomic fortunes of the individual, family and society especially in places were rehabilitative and prosthetic facilities are lacking. The aim of this study is to highlight the pattern of limb amputation surgeries in male patients in our centre with a view to suggesting possible ways of prevention and improvement in the functionality and quality of life of amputees. Patients and Methods: Case notes of male patients who had amputation surgeries during the study period in the centre were retrieved from the records department and relevant information extracted. The extracted data were analysed accordingly. Results: Sixty three male patients had 69 limb amputation surgeries in the centre during the study period. The mean age of the patients was 48.7 + 20.6 years. The most frequent level of amputation was at below knee level in 46% of cases followed by above knee in 17.4% of cases. The lower limb was involved in 74.5% of cases, the rest 25.5% involving the upper limb. Diabetic foot disease was the commonest indication for amputation in 37.7% of cases followed by trauma in 30.4% of cases. Wound infection was the most frequent post-operative complication occurring in 43.5% of wounds in this study. Conclusion: Limb amputation surgeries frequently involve male patients with diabetic foot disease and trauma ranking as the most common indications here. Preventive measures such education of diabetic patients on foot car and, public enlightenment on accident and trauma prevention strategies will go a long way in reducing the burden of amputation. Making prosthesis available and affordable to amputees is also suggested as a way of improving on the quality of life and functionality of amputees.
Prosthetics and Orthotics International, 2022
Background: Various literature have dealt with the physical aspect of amputation and the functional outcome after amputation. There are a few studies that give focused attention to the quality of life (QOL) of amputees. These studies are mostly from the developed countries. This study analyzed amputation as a whole and how it affects an individual physically, psychologically, emotionally, and socially, which would enable the health care providers to help the amputees to attain a better QOL. Study Design: Cross-sectional study Materials and Methods: This cross-sectional study was conducted on lower limb amputees. Data were collected using a proforma for demographic details and two pretested questionnaires-the World Health Organization QOL-Bref and prostheses-specific Trinity Amputation and Prosthesis Experience Scales-Revised questionnaires. The data were analyzed using SPSS software, version 20. Results: Amputation significantly affects all domains of the QOL. Age was a significant determinant of QOL of amputees, and it was found that the QOL decreased with an increase in age. 48.1% of the amputees were using a prosthetic device, and they were found to have a significantly better QOL. The prevalence of residual limb pain and phantom limb pain was 52.9% and 37%, respectively. Conclusion: Nearly half of the population perceived that their QOL was neither poor nor good. The QOL of the physical domain was better than the other domains. The most important factors that were found to be associated with QOL of amputees were age, duration since amputation, and use of prosthesis.