Physiotherapy Practice and Research - Volume 43, issue 1

Authors: O’Shea, Orlagh | Moran, Jonathan

Article Type: Editorial

DOI: 10.3233/PPR-229001

Citation: Physiotherapy Practice and Research, vol. 43, no. 1, pp. 1-1, 2022

Authors: Ward, Peter | O’Brien, Claire | Hogan, Laura | Howard, William | Mooney, Rebecca | Bernard, Paul | Corcoran, Grace

Article Type: Editorial

Keywords: Alternative care pathways, pre-hospital, older adult, therapist, paramedic

DOI: 10.3233/PPR-220663

Citation: Physiotherapy Practice and Research, vol. 43, no. 1, pp. 3-6, 2022

Authors: Fullen, Brona M. | O’ Shea, Orlagh | O’ Neill, Brenda | Moran, Fidelma | Cahalan, Roisin | Phelan, Deirdre | Hanrahan, Ciara | Broderick, Julie

Article Type: Research Article

Abstract: BACKGROUND: Respiratory physiotherapy is a core area of practice, but little is known about pre-qualification physiotherapy curricula across institutions. The purpose of this study was to identify and categorise the pre-qualification content of respiratory physiotherapy curricula across the island of Ireland. METHODS: This cross-sectional survey was conducted remotely and eight respiratory module coordinators/teaching leads participated. Respiratory physiotherapy curricular topics and assessment details from each participating institution were documented. Curricular topics were then grouped and categorised into discrete broader curricular topic areas by agreement. A representative from each higher education institution rated the curricular topic from their programme as …‘foundation’, ‘core’, ‘not essential but desirable’ or ‘broadly relevant’. Assessment strategies for each programme were documented. RESULTS: From 246 individual topics, seven broad category areas were generated which were operationally defined and divided into 41 content topics. Of the content topics 18 out of 41 (44%) topics were unanimously rated as core to the respiratory module by each participating programme. A diverse range of assessment strategies were employed across programmes with all including written and practical components. CONCLUSION: Between programmes and institutions, there was a reasonably high degree of overlap of the respiratory physiotherapy topic areas which are delivered within or outside of core respiratory modules. Content appears to be broadly standardised and appears to support the preparedness of graduates for practice in this area. The identification of ‘core’ respiratory topics in this study may be useful for the design of new respiratory physiotherapy modules or ongoing curricular review. Show more

Keywords: Respiratory physiotherapy, curriculum, education

DOI: 10.3233/PPR-220650

Citation: Physiotherapy Practice and Research, vol. 43, no. 1, pp. 7-15, 2022

Authors: Cahalan, Roisin | Russell, Anne Marie | Meade, Ciara | Hayes, Grainne

Article Type: Research Article

Abstract: BACKGROUND & PURPOSE: Pulmonary fibrosis (PF) is a debilitating, incurable disease. Strategies to optimise health-related quality of life and minimise symptom impact are advocated. Available treatment options such as pulmonary rehabilitation have been severely disrupted due to COVID-19. This feasibility study explored the clinical efficacy and acceptability of an online singing and breathing retraining programme (SingStrong) for people with PF. METHODS: The weekly online programme conducted over 12 weeks was comprised of 45-minute classes of mindfulness, breathing retraining, vocal exercises and singing conducted by a trained vocal coach. People with PF were invited to participate and sessions were …recorded for non-attenders. Demographic data were collected, and the St Georges Respiratory Questionnaire (SGRQ) and Idiopathic PF Patient Reported Outcome measure (IPF-PROM) were administered. The questionnaire also invited participants to provide feedback on the utility, enjoyability and main pros/cons of the intervention. Participation in the research element of the programme was not required to attend the weekly classes. RESULTS: Of 24 participants recruited, data from 15 (mean (Standard Deviation) age of 66 (8.7); male: n  = 8) who completed both pre and post-intervention questionnaires were analysed. Statistically significant improvements were recorded in the IPF-PROM (p  = 0.019) and self-reported quality of life (p  = 0.028). Class attendance by study participants and the broader PF group cumulatively, increased from 14 to 25 participants between weeks 1 and 12. Qualitatively, strong satisfaction with classes and improved efficacy in self-management of lung health, in particular breathlessness, were reported. CONCLUSIONS: Singing and breathing retraining interventions may endow biopsychosocial benefits for people with PF, in the presence of modest objective clinical gains. Singing programmes are popular and may provide helpful adjuncts to existing clinical strategies such as pulmonary rehabilitation. Show more

Keywords: Pulmonary Fibrosis, Singing for lung health, Online rehabilitation, SingStrong

DOI: 10.3233/PPR-210622

Citation: Physiotherapy Practice and Research, vol. 43, no. 1, pp. 17-25, 2022

Authors: Graur, Nissan | Dickstein, Ruth | Weiner, Paltiel | Weiss, Israela | Kramer, Mordechai R.

Article Type: Research Article

Abstract: BACKGROUND: Lung transplantation (LTx) is an established treatment option for patients with end-stage lung diseases. Nevertheless, exercise intolerance, respiratory muscle function impairment, functional disability, and peripheral muscle weakness often persist following LTx. PURPOSE: To examine the effectiveness of a pulmonary rehabilitation (PR) program and home-based inspiratory muscle training (IMT) alone or in combination, in post lung transplantation (LTx) patients. METHODS: In a prospective pilot study a sample of 22 patients who had undergone LTx 4–18 months prior, were randomized to groups of PR alone, or combined with home-based IMT, or IMT alone, for six months: four …months in the intervention program and two months of follow-up. Inspiratory muscle strength was assessed by measuring the maximal inspiratory pressure (MIP). RESULTS: There was a statistically significant increase in MIP values as well as in the 6-min-walk-test, only in the PR combined with home-based IMT, and IMT exercise groups. From baseline after 2- and 4-months intervention and at 6-months at follow-up, there was a statistically significant correlation between MIP and Maximum Voluntary Ventilation (MVV) values. CONCLUSIONS: Pulmonary rehabilitation (PR) program combined with inspiratory muscle training (IMT) or home-based IMT alone, in post lung transplantation patients, seems to be the best exercise combination for achieving the optimal effect, in inspiratory muscle strength and exercise capacity, with evidence for long-term benefits. Patients should be encouraged to participate in a PR program that includes home-based IMT exercise, especially in times of restricted mobility, as currently due to the COVID-19 pandemic. Show more

Keywords: Lung transplantation, pulmonary rehabilitation, inspiratory muscle training, 6-min-walk-test, maximal inspiratory pressure

DOI: 10.3233/PPR-210574

Citation: Physiotherapy Practice and Research, vol. 43, no. 1, pp. 27-35, 2022

Authors: Najafabadi, Mahboubeh Ghayour | Niazi, Sepideh | Mortazavian, Soudabehsadat | Khah, Amir Sobhrakhshan | Ingle, Lee

Article Type: Research Article

Abstract: AIM: To determine the effects of a structured, moderate-intensity, early cardiac rehabilitation (CR) program on physical function and psychological wellbeing in patients following aortic root replacement. MATERIALS AND METHODS: Patients were randomly assigned to either an 8-week (24 sessions) cardiac rehabilitation (CR) program, 4 to 6 weeks after aortic root replacement using the Bentall procedure, or to an age- and sex-matched control group undertaking no structured exercise. Physical function (via exercise treadmill test (ETT)) and psychological wellbeing (assessed via DASS-21 and SF36) were assessed before and following 8-weeks of CR. RESULTS: 30 patients (15 in the …control (mean age: 37±10 years) and 15 in the intervention group (mean age: 38±11 years)) completed the 8-week CR programme and no adverse events were reported over the intervention period. In the CR group, all sub-components of the SF-36 and DASS-21 increased (all P  < 0.05), showing an overall improvement in psychological wellbeing following the intervention. Distance walked on the ETT (improved significantly following 8-weeks of CR (490±167 m v 659±141 m; Λ improvement = 169 m; P  < 0.05). There were no changes in physical function and psychological wellbeing in the controls (P  > 0.05). A significant group-by-time interaction effect was evident for physical function and all sub-components of the SF-36 and DASS-21 (all P  < 0.05) highlighting significant improvements in outcomes in the CR group compared to controls. CONCLUSIONS: This small sample, aerobic-based, moderate-intensity CR is safe and effective, and can be tolerated only 4–6 weeks after complex aortic root replacement surgery. Show more

Keywords: Cardiac rehabilitation, Bentall procedure, depression, anxiety

DOI: 10.3233/PPR-210541

Citation: Physiotherapy Practice and Research, vol. 43, no. 1, pp. 37-43, 2022

Authors: Kim, Young Joo | Swift, Damon L. | Houmard, Joseph A. | Wu, Qiang | Sears, Samuel F. | Paul, Alyssa M.

Article Type: Research Article

Abstract: BACKGROUND: Little is known about predictors of activity participation that are objectively measured in cardiac rehabilitation (CR) graduates. This prospective observational study aimed to determine the predictors of objectively measured activity participation among adults with chronic cardiac conditions who have completed Phase II CR. METHODS: Twenty-five adults with chronic cardiac conditions graduating from traditional CR program participated in the study. The outcome variable was an activity participation level measured by light-to-vigorous intensity physical activity (LVPA) minutes using ActiGraph GT9X Link accelerometer after CR discharge. Covariates were collected at the discharge from CR, and outcome variables were collected at …1 month, 3 months, and 9 months post CR discharge. RESULTS: Gender, standardized LVPA at CR discharge, body mass index, and motivation for physical activity and leisure were significantly associated with the activity participation levels at 1 month, 3 months, and/or 9 months post CR discharge. Gender, standardized LVPA at CR discharge, highest education completed, and depressive symptoms significantly predicted the activity participation levels at 1 month (R2  = 0.69, p  < 0.001), 3 months (R2  = 0.65, p  < 0.001), and/or 9 months (R2  = 0.80, p  < 0.001) post CR discharge. Female CR participants who were more active, had more than high school education, and showed more depressive symptoms at CR discharge were more likely to be active post CR. CONCLUSIONS: CR participants may benefit from individualized approach to plan their days post CR and application-focused and education-level sensitive sessions to understand the importance of activity participation maintenance post CR. Show more

Keywords: Activity participation, light-to-vigorous intensity physical activity, chronic cardiac conditions, ActiGraph

DOI: 10.3233/PPR-210586

Citation: Physiotherapy Practice and Research, vol. 43, no. 1, pp. 45-53, 2022

Authors: Hassan, Ali Mohammed | Mohammed Kamel, Sarah Medhat | Abdelhamid, Ahmed Samir | Aboelnasr, Emad | Alaparthi, Gopala Krishna | Bairapareddy, Kalyana Chakravarthy | Hegazy, Fatma Abdelfattah

Article Type: Research Article

Abstract: BACKGROUND: After cardiac surgery, various pulmonary complications develop which require specific care. These complications affect pulmonary functions and can lengthen the hospital stay of patients, causing increased hospital costs and becoming an important cause of morbidity and mortality. OBJECTIVES: To investigate the short-term effect of inspiratory muscle training on pulmonary function after mitral valve replacement. METHODS: A sample of Thirty five patients (35.5±3.29 years) who underwent mitral valve replacement. Spirometric parameters were measured before and after intervention including forced vital capacity (FVC), forced expiratory volume in the first second (FEV1) and ratio of forced expiratory volume …in the first second to forced vital capacity (FEV1/FVC). All participants had received postoperative Inspiratory muscle training (IMT) from the first day in the inpatient unit after discharge from intensive care unit till hospital discharge. Paired t -test was used to investigate differences between means of pulmonary function measures (P < 0.05). Effect size was calculated and post hoc power analysis was performed. RESULTS: After one week of postoperative IMT there was a statistically significant improvement in the studied spirometric parameters (FVC, FEV1, FEV1/FVC) (p  = 0.01). All studied spirometric parameters showed very large effect size (d >0.8). The post hoc power analysis revealed that the study power was more than 90%. CONCLUSION: One week of post-operative IMT may have a beneficial short-term effect in improving pulmonary functions after mitral valve replacement. Show more

Keywords: Inspiratory muscle training, Pulmonary functions, Mitral valve replacement, Cardiopulmonary rehabilitation

DOI: 10.3233/PPR-210553

Citation: Physiotherapy Practice and Research, vol. 43, no. 1, pp. 55-61, 2022

Authors: Ward, Susan | MacDermott, Emma Jane | Deane, Janet | Simmonds, Jane | Mockler, David | Dockrell, Sara

Article Type: Research Article

Abstract: INTRODUCTION: Joint hypermobility (JH) is a term used to define active or passive joint range of motion that is beyond normal range, accounting for age, sex, and ethnicity. Symptomatic hypermobility is a term that can be used when symptoms are thought to be associated with JH. Children and young people with symptomatic hypermobility complain of musculoskeletal symptoms but also may report symptoms from other domains including gastrointestinal, cardiovascular, psychological, and urogenital. Many of these symptoms are not included in formal diagnostic criteria yet may impact negatively on their quality of life. The pattern of these symptoms may change with age. …PURPOSE: To map the literature on clinical characteristics of symptomatic hypermobility in an age and developmental context, to improve our understanding and assist in the clinical assessment of children and young people with symptomatic hypermobility. METHODS: This systematic scoping review will be conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) methodology. Studies that include children and young people from birth to 24 years with a confirmed diagnosis of symptomatic hypermobility, HSD or hEDS using internationally recognised criteria or equivalent diagnoses will be included. Data extraction and analysis will be undertaken using an iterative process. DISCUSSION: Mapping and synthesis of the data will be carried out and gaps and limitations in the literature will be acknowledged. Results will be disseminated in a peer reviewed journal. The search strategy will be made available publicly for transparency. Show more

Keywords: Symptomatic hypermobility, children, young people, clinical characteristics

DOI: 10.3233/PPR-210601

Citation: Physiotherapy Practice and Research, vol. 43, no. 1, pp. 63-69, 2022

Authors: Ryan, Jennifer M. | Lavelle, Grace | Noorkoiv, Marika | Kiernan, Damien | Theis, Nicola | Little, Úna | Shortland, Adam | Malone, Ailish

Article Type: Research Article

Abstract: INTRODUCTION: The aim of this study was to investigate the association between gait parameters, gross motor function and physical activity (PA) in young people with cerebral palsy (CP). METHODS: Thirty-eight adolescents aged between 10–19 years with spastic CP in GMFCS levels I-III (mean [standard deviation] age 13.7 [2.4 ] yr; 53%female) were included in this cross-sectional study. Hip, knee and ankle joint excursion and stance time was assessed using 3D gait analysis. Self-selected walking speed was assessed during a timed 10 m overground walk and treadmill walking. Gross motor function was assessed using dimensions D and E of the Gross …Motor Function Measure (GMFM-66). Moderate-to-vigorous PA, light PA and step-count were assessed using an accelerometer. Linear regression was used to examine associations. RESULTS: After adjusting for age, sex and GMFCS level, percentage stance time was associated with dimension E of the GMFM-66 (β= –0.29, 95%CI –0.54 to –0.05). There was no evidence that any other gait parameters were associated with GMFM-66 dimensions D or E. There was also no evidence that gait parameters or GMFM-66 dimensions D or E were associated with step-count or time in PA after adjusting for age, sex and GMFCS level. DISCUSSION: The findings provide an insight into the complexity of the relationship between gait quality or ability at the impairment level, function as measured in a controlled environment, and the performance of habitual PA, which is essential for health among children with CP. Show more

Keywords: Developmental neurology and neurodisability, functional performance, gait, gait analysis, mobility limitation, paediatrics

DOI: 10.3233/PPR-200411

Citation: Physiotherapy Practice and Research, vol. 43, no. 1, pp. 71-80, 2022

Authors: Svensdotter, Helene | Danielsson, Louise | Seferiadis, Aris

Article Type: Research Article

Abstract: PURPOSE: To investigate the association between forward head posture (FHP) and neck pain disability in patients with chronic whiplash associated disorders (WAD). METHODS: This study was a secondary analysis based on data from a randomized controlled study. The study involved patients with chronic WAD reporting their disability using the Neck Disability Index (NDI). FHP was measured with a goniometer. Analyses of correlations and logistic regressions were performed controlling for age, gender, duration of symptoms, WAD-grade (the Quebec Task Force on Whiplash-Associated Disorders classification), bodily pain (the Short-Form 36 Health Survey (SF-36) and kinesiophobia, an irrational fear of physical …movement and activity (the Tampa Scale of Kinesiophobia (TSK-SV). RESULTS: The inclusion criteria was fulfilled by 113 patients (81 women, 32 men). Mean age 48.1 years. Mean duration of symptoms 9.7 years. There was no significant correlation between FHP and neck pain disability (rs  = 0.004, p  = 0.968). A logistic regression analysis showed no significance for FHP neither with (p  = 0.418) nor without (p  = 0.991) control for age, gender, duration of symptoms, WAD-grade, kinesiophobia and bodily pain. In the multiple model kinesiophobia (p  = 0.013) and bodily pain (p  = < 0.001) were the only significant predictors. Kinesiophobia was also significantly correlated with both neck pain disability (rs  = 0.467, p  < 0.001) and FHP (rs  = 0.202, p  = 0.047), thus being a confounder to the possible correlation between these variables. CONCLUSIONS: There is no significant correlation between neck pain disability and FHP for patients with chronic WAD. Results suggest that physiotherapists should increase their focus on kinesiophobia, since it is associated with both FHP and neck pain disability. Show more

Keywords: Whiplash injuries, neck pain, pain, intractable, posture, pain measurement

DOI: 10.3233/PPR-200460

Citation: Physiotherapy Practice and Research, vol. 43, no. 1, pp. 81-90, 2022

Authors: Osama, Muhammad

Article Type: Research Article

Abstract: BACKGROUND: Even though studies have reported impaired postural stability (PS) and risk of fall in non-specific low back pain (LBP), evidence is relatively scarce in terms of discogenic LBP or in persons with degenerative disc disorders of the lumbar spine. OBJECTIVE: To determine the differences in terms of PS, fall risk and sensory integration of balance in persons with discogenic LBP as compared to healthy controls. METHODS: A cross sectional comparative study was conducted on 60 participants, out of which 30 had discogenic LBP and 30 were healthy controls. The variables of interest included PS, fall …risk score (FRS) and clinical test of sensory integration of balance (CTSIB), and the data was collected using Biodex Balance SystemTM SD, with higher scores signifying poorer outcomes. RESULTS: Persons with discogenic LBP scored significantly (p  < 0.05) higher in terms of overall PS index [Mean difference = 2.33 (95% CI 1.38, 3.28)], anteroposterior PS index [Mean difference = 1.87 (95% CI 0.84, 2.90)] and mediolateral PS index [Mean difference = 0.82 (95% CI 0.43, 1.21)], FRS [Mean difference = 2.92 (95% CI 2.36, 4.8)] and CTSIB [Mean difference = 1.67 (95% CI 1.28, 2.06)] as compared to healthy controls. Both healthy controls and persons with discogenic LBP revealed higher anteroposterior postural stability index as compared to mediolateral postural stability index (p  < 0.001). CONCLUSIONS: Persons with discogenic low back pain exhibit greater risk of fall and poorer postural stability and sensory integration of balance as compared to healthy controls. It is suggested that fall risk, postural stability and sensory integration of balance should be considered as outcome measures in clinical management of such patients. Show more

Keywords: Balance, disc prolapse, fall risk, low back pain, postural control, postural stability

DOI: 10.3233/PPR-210593

Citation: Physiotherapy Practice and Research, vol. 43, no. 1, pp. 91-96, 2022

Authors: Mehta, Payal | Prabhakar, Ashish John | Eapen, Charu

Article Type: Research Article

Abstract: BACKGROUND: Despite recent gain in popularity and the proposed theories of effectiveness of kinesio taping (KT), there remains a lack of sufficient literature on the effect of kinesio taping on maximal voluntary contraction, proprioception and upper limb reaction time. OBJECTIVE: To assess the effect of kinesio taping and fatigue on maximal voluntary contraction, proprioception of the shoulder and upper limb reaction time in recreational badminton players. PARTICIPANTS: 40 recreational badminton players were included in the study. METHODS: The subjects were randomly allocated into–1) the KT group and 2) Placebo group. Maximal voluntary contraction, proprioception …and reaction time was measured before the application of KT to the shoulder and after 35 minutes of playing badminton with KT. ANALYSIS: Wilcoxin signed rank test was used for within group comparison and Mann Whitney U test was used for between group comparison. RESULTS: For proprioception within group comparison showed a significant difference at 60° of flexion and 120° of abduction in the control group. On comparison of change in effect size, a significant difference was seen at 60°, 90° of flexion and at 90° of external rotation. For maximal voluntary contraction, between group comparison showed a significant difference in all muscle groups except for the internal rotators.For reaction time, a significant difference was seen on between group comparison. (p  < 0.05) CONCLUSION: Kinesio taping may help in maintaining proprioception and strength of the shoulder and improving reaction time in badminton players even after a fatiguing game. Show more

Keywords: Kinesio taping, shoulder, maximal voluntary contraction, proprioception, upper limb, reaction time, recreational badminton players

DOI: 10.3233/PPR-210522

Citation: Physiotherapy Practice and Research, vol. 43, no. 1, pp. 97-105, 2022

Authors: Paquete, Manuel | Ferreira, Ana | Meireles, Ana | Harry-Leite, Pedro | Goncalves-Lopes, Sónia | Lourenço, Joana | Soares, Denise

Article Type: Research Article

Abstract: BACKGROUND: It is known, among the elderly population, the decrease in functional capacity to perform daily free-living activities, with the occurrence of falls quite frequently. The muscular component must be prepared for a better performance in motor tasks, reason why the application of Kinesio Taping™ band appears as an intervention to consider, so the aim of this study is to analyze the effect of the Kinesio Taping™ method on the balance of a senior group. METHOD: A sample of 28 subjects was divided into 2 groups: a control group (CG) and an experimental group (EG). The …balance was assessed using two scales: The Time-UP & Go Test (TUG) and Berg Balance Scale (BBS). At first, individuals from both groups were assessed using both Scales. Subsequently, to the individuals belonging to EG, the Kinesio Taping™ method was applied (KT™ ), in the anterior tibial and peroneal in both lower limbs in CG KT™ was applied as a placebo. A day later, in a second visit, the performance of both groups was again evaluated using the mentioned scales. RESULTS: In CG, no statistically significant differences were observed in between testing days, (TUG day 1 vs TUG day 2: p  = 0.842); (BBS day 1 vs BBS day 2: p  = 0.157). On the other hand, statistically significant differences were observed in the experimental group, where TUG performance was faster after KT™ (p  = 0.001) and BBS was higher (p  = 0.002). CONCLUSION: The results demonstrate that the Kinesio Taping™ application had positive effects on balance and these results could help the prevention of falls in the elderly. Show more

Keywords: Balance, muscle activation, anterior tibial, peroneal

DOI: 10.3233/PPR-210542

Citation: Physiotherapy Practice and Research, vol. 43, no. 1, pp. 107-112, 2022

Authors: Cronin, Eimear | Hickey, Paula | Lynch, Peter | Monaghan, Kenneth

Article Type: Research Article

Abstract: Neuropilates, that is, the practice of pilates in a patient with a neurological condition, may benefit post stroke patients through improving their strength, postural control, alignment and stability, with previous studies showing significant improvements in balance and gait parameters post pilates interventions. This case study aimed to investigate the feasibility and outcomes of an online, remotely supervised one to one pilates class, once a week for 6 weeks with a post stroke patient. Outcomes measured included gait and balance through the “Timed Up and Go (TUG)” test, the “Five Times Sit to Stand (5TSTS)” test, the “Activities specific Balance Confidence …(ABC) scale” and the “Tinetti” balance and gait assessment. Quality of life was also measured by the “Stroke Specific Quality of Life (SSQOL)” Scale and muscle tone was measured through use of the “Modified Ashworth Scale (MAS)”. Feasibility was assessed qualitatively based on information gathered from the client satisfaction questionnaire and the patient’s tolerance of the programme. Results demonstrated that the patient enjoyed and tolerated the programme well with modifications and that he would prefer online exercise training over face to face in the future. The patient improved his TUG score and his SSQOL score beyond the minimal detectable change. Smaller improvements were also seen in the 5TSTS test, the ABC scale and the Tinetti assessment. Mixed results were seen for muscle tone. Typical neuropilates exercise sets for post stroke patients in standing and seated positions are given as well as advice and protocols for ensuring high levels of safety with online exercising. Show more

Keywords: Pilates, rehabilitation, physiotherapy, stroke, telehealth

DOI: 10.3233/PPR-220641

Citation: Physiotherapy Practice and Research, vol. 43, no. 1, pp. 113-124, 2022

Authors: Curtin, Kate | Walsh, Mary | Stow, Jacqui | Malone, Ailish

Article Type: Research Article

Abstract: PURPOSE: To determine if people who walked with a lower limb prosthesis on discharge from rehabilitation continued to 20 weeks after discharge. MATERIALS AND METHODS: An observational cohort study design. People with major lower extremity amputation (LEA) who were discharged from rehabilitation using a prosthesis to walk and were due for prosthetic review appointment (20 weeks following discharge) during the period of data collection were eligible to be included. The primary outcome was the continuation of walking with a lower limb prosthesis at this time point (T2). Secondary outcome measures were: Timed Up and Go (TUG), Two Minute …Walk Test (2MWT), SIGAM score, Locomotor Capability Index-5 (LCI-5), and Orthotic Prosthetic User Survey- Quality of Life (OPUS-QOL). Secondary outcomes were assessed at time of discharge from rehabilitation (T1) and repeated at T2. Statistical analysis was carried out comparing the results of the secondary outcome measures at T1 and T2. RESULTS: 22/28 participants were still walking with their prostheses at T2. Five of the six who abandoned walking with their prostheses did so because of issues with the skin on their residuum or contralateral foot. Participants who continued to walk with their prostheses demonstrated a statistically significant improvement in TUG (5.01 seconds, p  < 0.01) and 2MWT (11.35 metres, p  < 0.01) between the two time points. No statistically significant difference was found in LCI-5 or OPUS QOL scores between the two time points. CONCLUSION: Most participants continued to walk with their prosthesis and experienced further improvements in their exercise tolerance and decrease in their risk of falls after discharge. Show more

Keywords: Prosthetic rehabilitation, prosthetic mobility, prosthetic limb abandonment, prosthetic outcomes

DOI: 10.3233/PPR-210618

Citation: Physiotherapy Practice and Research, vol. 43, no. 1, pp. 125-132, 2022