Functional Status and Factors Influencing the Rehabilitation Outcome of People Affected by Above-Knee Amputation and Hemiparesis

Brunelli S, Averna T, Porcacchia P, Paolucci S, Di Meo F, Traballesi M. Functional status and factors influencing the rehabilitation outcome of people affected by above-knee amputation and hemiparesis. Objectives: To evaluate the functional status of people with transfemoral amputation and hemiparesis and to identify the factors that influence rehabilitation outcome after inpatient treatment. Design: Retrospective study. Setting: Rehabilitation hospital. Participants: Forty-five patients (30 men, 15 women; mean age, 69±9y) with intact mental status affected by unilateral transfemoral amputation for vascular disease and mild or moderate hemiparesis. Interventions: Not applicable. Main Outcome Measures: Barthel Index, Barthel Index effectiveness, and Locomotor Capabilities Index (LCI) scores were measured. The following factors were studied: side and cause of amputation, side and severity of hemiparesis, sequence and laterality of dual impairment, time interval between impairments, and hospital length of stay. Results: At discharge, mean Barthel Index and LCI scores ±1 standard deviation were 79±12 and 15±5.6, respectively; Barthel Index effectiveness was 55±23.8. Only 2 patients ambulated without walking aids. Barthel Index effectiveness was better in patients with mild hemiparesis than in patients with more severe impairment. Ipsilateral localization of dual impairment increased the probability of higher LCI scores. Conclusions: Selected patients with dual impairment can recover the ability to walk. Severity of hemiparesis and laterality were the 2 clinical factors that had the greatest influence on functional measures.