Physiotherapy Rehabilitation for Individuals with Lower Limb Amputation: A 15-Year Clinical Series
Physiotherapy Rehabilitation for Individuals with Lower Limb Amputation: A 15-Year Clinical Series
复制标题
DOI：
10.1002/pri.1529
复制
发表时间：
2013-06-01
影响因子：
1.7
通讯作者：
Crotty, Maria
中科院分区：
文献类型：
--
作者：
Hordacre, Brenton;Birks, Vicki;Crotty, Maria
背景和目的。截肢者是澳大利亚康复单位的核心群体，他们的指数住院时间很长。遣返总医院为南阿德莱德人口（350，000人）提供一般康复服务，并包括一个现场假肢制造设施。使用RGH的物理治疗数据库，我们试图回答以下问题：15年以上接受下肢假肢康复的患者的人口统计学和临床特征是什么？康复效果的时间是多少？15年来，随着服务提供的变化，这些变化是如何发生的？方法.本文是一项回顾性观察性研究，使用了南澳大利亚一家医院（RGH）的531例下肢截肢患者的物理治疗临床数据库（1996-2010年）。在提供服务方面有两个变化：1）1998年推出的多学科临时假肢方案; 2）2000年推出的可移动刚性敷料。结果指标为患者人口统计学资料、临床特征和康复时间结果标记。结果平均年龄为68岁（标准差[SD]：15），69%为男性，80%为血管障碍，68%为经胫骨。住院患者的总体中位康复住院时间（RLOS）为39天（四分位距[IQR]：26-57）。每年进入康复期的截肢患者有更多的合并症（β：0.08; 95%置信区间：0.05-0.11）。IPP的引入与初始假体铸造、独立行走和住院RLOS的时间显著缩短相关。RRD的引入与伤口愈合、初始假体铸造和独立行走时间的显著缩短相关。结论.截肢的个体通常是经胫骨截肢的老年血管障碍男性。IPP和RRD的引入成功地缩短了康复结果的时间，包括独立行走，这一结果很少报告，但对患者和物理治疗师具有重要意义。版权所有（C）2012约翰威利父子有限公司
Background and Purpose. Individuals with amputations are a core group in Australian rehabilitation units that have a long index length of stay. The Repatriation General Hospital (RGH) offers general rehabilitation services to the population of Southern Adelaide (a population of 350,000) and includes an on-site prosthetic manufacturing facility. Using a physiotherapy database at the RGH, we sought to answer the following questions: What are the demographic and clinical characteristics of patients admitted for lower limb prosthetic rehabilitation over 15 years? What are the times to rehabilitation outcomes? How have these changed over 15 years with changes in service delivery? Methods. This paper is a retrospective observational study using a physiotherapy clinical database (1996-2010) of 531 consecutive individuals with lower limb amputation at one South Australian hospital (RGH). There were two changes in service delivery: 1) a multidisciplinary interim prosthetic programme (IPP) introduced in 1998 and 2) removable rigid dressings (RRDs) introduced in 2000. Outcome measures were patient demographics, clinical characteristics and time to rehabilitation outcome markers. Results. Mean age was 68 years (standard deviation [SD]: 15), with 69% male, 80% dysvascular and 68% transtibial. The overall median inpatient rehabilitation length of stay (RLOS) was 39 days (interquartile range [IQR]: 26-57). Individuals with amputation entering rehabilitation each year had a higher number of co-morbidities (beta: 0.08; 95% confidence interval: 0.05-0.11). Introduction of the IPP was associated with a significant reduction in time to initial prosthetic casting, independent walking and inpatient RLOS. Introduction of RRDs was associated with a significant reduction in time to wound healing, initial prosthetic casting and independent walking. Conclusions. Individuals with amputation were typically elderly dysvascular men with transtibial amputations. Introduction of the IPP and RRDs successfully reduced time to rehabilitation outcomes including independent walking, an outcome that is rarely reported but is of significance to patients and physiotherapists. Copyright (C) 2012 John Wiley & Sons, Ltd.