Comorbidities and Mobility in Lower Limb Prosthesis Users

Objective To determine the impact of comorbidities on mobility in patients with lower limb prostheses. Design Cohort database chart review examining mobility in lower limb prosthesis users grouped according to comorbidities. Regression models were used to determine significant predictor comorbidities for mobility. General linear univariate models were implemented to investigate differences in mobility among cohorts (n=596). Results Patient age and history of stroke, peripheral vascular disease, and anxiety/panic disorders were predictors of decreased mobility. After adjusting for covariates, the differences in mobility reported by patients over age 65 years was compared to those under age 65, in addition we compared those with history of peripheral vascular disease to those without. The comparative analyses for both categories did not satisfy the minimal clinically important difference. There were no significant differences when comparing overall comorbid health after adjusting for covariates. Conclusion Clinicians should consider patient age and history of stroke, peripheral vascular disease, or anxiety/panic disorders when optimizing a lower limb prosthesis users' mobility as these variables may be predictive of modest but clinically meaningful decreased prosthetic mobility. By contrast, common comorbid health conditions such as arthritis, COPD, congestive heart failure, and diabetes do not appear predictive of decreased mobility among lower limb prosthesis users. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. Corresponding Author: Shane R. Wurdeman, PhD, Department of Clinical and Scientific Affairs, 11155 S. Main St. Hanger Clinic, Houston, TX, USA 77025, Email: swurdeman@hanger.com, Phone: 512-777-3800; Fax: 512-605-2786 Author Disclosures: Support for this work was partially provided by a Small Grant Award (EB-043016) from the American Orthotics and Prosthetics Association. The results of this study were recently presented as part of a symposium on outcomes at the American Congress of Rehabilitation Medicine in October 2017. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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