Predictors of non-use of prostheses by people with lower limb amputation after discharge from rehabilitation: development and validation of clinical prediction rules
MetadataShow full item record
Questions: Can rules be developed to predict the risk of non-use of prostheses by people with lower limb amputation following discharge from rehabilitation? Are these clinical prediction rules valid? Design: Retrospective and prospective cohort study designs. Participants: Consecutive tertiary rehabilitation patients: 135 retrospective (103 males, mean age = 56 years, SD 15) and 66 prospective (58 males, mean age = 54 years, SD 16). Method: Medical records were audited for potential predictor variables. Retrospective participants were interviewed at a median of 1.9 years after discharge (IQR 1.4 to 2.5) and prospective participants at a median of 1.3 years (IQR 1.1 to 1.4). Results: Clinical prediction rules were identified at 4, 8 and 12 months after discharge, and validated. Amputation levels above transtibial and mobility-aid use were common predictors for all three time frames. At 4 months, if four out of five predictor variables were present (LR+ = 43.9, 95% CI 2.73 to 999+), the probability of non-use increased from 12 to 86% (p < 0.001). At 8 months, if all three predictor variables were present (LR+ = 33.9, 95% CI 2.1 to 999+), the probability of non-use increased from 15 to 86% (p < 0.001). At 12 months, if two out of three predictor variables were present (LR+ = 2.8, 95% CI 0.9 to 6.6), the probability of non-use increased from 17 to 36% (p < 0.031). Conclusions: These validated clinical prediction rules have implications for rehabilitation and service model development.
This open access article is distributed under the Creative Commons license http://creativecommons.org/licenses/by-nc-nd/3.0/
Showing items related by title, author, creator and subject.
Locomotor Performance During Rehabilitation of People With Lower Limb Amputation and Prosthetic Nonuse 12 Months After DischargeRoffman, C.; Buchanan, J.; Allison, Garry (2015)Background: It is recognized that multifactorial assessments are needed to evaluate balance and locomotor function in people with lower limb amputation. There is no consensus on whether a single screening tool could be ...
The role of functional, radiological and self-reported measures in predicting clinical outcome in spondylotic cervical radiculopathyAgarwal, Shabnam (2011)BackgroundCervical radiculopathy (CR) results in significant disability and pain and is commonly treated conservatively with satisfactory clinical outcomes. However, a considerable number of patients require surgery to ...
Developing completion criteria for rehabilitation areas on arid and semi-arid mine sites in Western AustraliaBrearley, Darren (2003)Continued expansion of the gold and nickel mining industry in Western Australia during recent years has led to disturbance of larger areas and the generation of increasing volumes of waste rock. Mine operators are obligated ...