150.
Early independence in basic amputee activities but extremely poor
one-leg balance following major non-traumatic lower limb amputation
Morten Tange Kristensen, Anni Østergaard Nielsen, Berit Jakobsen, Kirsten
Juel Nielsen, Ulla Madsen Topp
Department of Physiotherapy and Orthopaedic Surgery Hvidovre University
Hospital; Department of Physiotherapy, Hvidovre University Hospital;
Department of Physiotherapy, Hvidovre University Hospital; Department of
Physiotherapy, Hvidovre University Hospital; Department of Physiotherapy,
Hvidovre University Hospital
Background:
Knowledge of the postoperative one-leg balance level and time
to independence in basic activities is sparse in patients following major lower
limb amputation.
Purpose / Aim of Study:
To examine the in-hospital association between one-
leg balance performance and time to independence in basic amputee activities
following major non-traumatic unilateral lower limb amputation.
Materials and Methods:
Thirty-six patients (23 men) with a mean (SD) age
of 67.4 (10.6) years, admitted to an acute orthopaedic ward and able to stand
on the intact leg two weeks post-amputation. Amputations were related to
arteriosclerosis (n=17), diabetes (n=15), and other causes (n=4), while 58%
had an ASA-score >2. Patients were evaluated for their ability to perform basic
amputee transfer activities from lying in bed to sitting on bedside, bed to
wheelchair, indoor wheelchair manoeuvring, and sitting to standing with
support. Each patient performed five one-leg timed balance trials without
support with a 30-second seated rest interval.
Findings / Results:
The 19 below-knee and 17 above-knee amputee patients
performed the balance test at a mean of 14.5 (4.5) days following amputation,
with a median (25-75% quartile) best standing time of 2.9 (1.7-8.2) seconds
with only seven patients able to stand for more than 10 seconds. All patients
(
except one) reached independence in the four basic activities at a mean of 7.9
(4.3)
days post-amputation. Performances were not significantly related to age,
gender, diagnosis, or the amputation level.
Conclusions:
Non-traumatic lower limb amputee patients present extremely
poor one-leg standing balance, but regain independence in basic amputee
activities shortly after surgery. There is an urgent need for well-designed in-
hospital physiotherapy studies, evaluating whether e.g. specific balance or
strength training improves balance.
