Faculty University of Kentucky PM&R Lexington, Kentucky, United States
Objectives: Of the approximately 1.6 million amputees living in the United States, an estimated 282,000 are living with a unilateral transtibial amputation. For these patients, inpatient rehabilitation maintains range of motion, restores balance, and increases strength and mobility; however, decreased patient confidence can hinder progress. Supporting the patient’s body weight during physical activities can help overcome such limitations. The purpose of this study was to evaluate the effect of an over-the-ground, dynamic body-weight support system on the inpatient rehabilitation for patients with below knee amputations (BKA).
Design: For this study, the discharge data of seven below knee amputees (five unilateral; two bilateral) were evaluated. Each of these patients utilized a dynamic, body-weight support system during their inpatient rehabilitation admission. The motor Functional Independence Measure (FIM) scores at admission and discharge were used as the primary outcome, which were compared to previously published historical data for below knee amputees in inpatient rehabilitation.
Results: Admission motor FIM scores for patients in this study were not significantly different from historical admission scores. The patients that utilized a dynamic body-weight support system during inpatient rehabilitation had motor FIM scores at discharge that were 21% and 36% higher than historical counterparts for unilateral BKA and bilateral BKA patients, respectively. Changes in motor FIM score were nearly doubled for unilateral BKA patients (84% greater) and more than double for unilateral BKA patients (124% greater).
Conclusions: Although the data suggests that a dynamic body-weight support system can meaningfully improve rehab performance of below knee amputees, the sample sizes (n=5 unilateral BKA; n=2 bilateral BKA) will need to be increased to improve the statistical power of this study. This study represents a strong case that the rehabilitation potential of below knee amputees can be maximized with a dynamic body-weight support system.