Effectiveness of an Evidence-Based Amputee Rehabilitation (EBAR) Program: A Pilot Randomized Controlled Trial.

Abstract

BACKGROUND Despite the prevalence of lower limb amputation (LLA) only a small percentage of people with LLA actually receive physical therapy post amputation and are rehabilitated to their full potential level of function. There is a need for the development of a rehabilitation program that targets impairments and limitations specific to people with LLA. OBJECTIVE The objective of this study was to determine whether the Evidence-Based Amputee Rehabilitation (EBAR) program would improve functional mobility of people with unilateral transtibial amputation (TTA) who have already completed physical therapy and prosthetic training. DESIGN This study was a randomized, wait-list control, single-blinded pilot clinical trial. SETTING This study utilizes participants who had received post amputation rehabilitation to varying degrees, either in an inpatient and/or outpatient settings. PARTICIPANTS The participants in this study included veterans and non-veterans with unilateral TTA due to dysvascular disease and trauma. INTERVENTION This study included a prescription-based rehabilitation program for people with amputations. MEASUREMENTS Results were measured with The Amputee Mobility Predictor with (AMPPro) and without a prosthesis (AMPnoPro) and 6-minute Walk Test (6MWT) at baseline and at the end of the 8-week intervention. RESULTS The intervention group improved on the AMPPro scores (36.4 to 41.7), AMPnoro scores (23.2 to 27.1), and 6MWT distance (313.6 to 387.7 m).The effect size for the intervention was very large (1.32). In contrast, the wait-list control group demonstrated no change in AMPPro scores (35.3 to 35.6), AMPnoPro scores (24.7 to 25.0), and 6MWT distance (262.6m to 268.8m). LIMITATIONS The sample size was small. Three-hundred twenty-six potential candidates were screened with 306 unable to meet inclusion criteria or unwilling to participate. CONCLUSION People with unilateral TTA who received EBAR program demonstrated significant improvement in functional mobility with the majority of participants (66.7%) improved at least one K-level (58.3%) and greater than the minimal detectable change (66.7%).

Authors

• R. Gailey
• I. Gaunaurd
• M. Raya
• N. Kirk-Sanchez
• L. Prieto-Sanchez
• K. Roach

Keywords

• Medicine