Caroline E Roffman1, John Buchanan1, Garry T Allison1. 1. School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University and Royal Perth Hospital, Perth, Australia.
Abstract
QUESTIONS: Can rules be developed to predict the risk of non-use of prostheses by people with lower limb amputation following discharge from rehabilitation? Are these clinical prediction rules valid? DESIGN: Retrospective and prospective cohort study designs. PARTICIPANTS: Consecutive tertiary rehabilitation patients: 135 retrospective (103 males, mean age = 56 years, SD 15) and 66 prospective (58 males, mean age = 54 years, SD 16). METHOD: Medical records were audited for potential predictor variables. Retrospective participants were interviewed at a median of 1.9 years after discharge (IQR 1.4 to 2.5) and prospective participants at a median of 1.3 years (IQR 1.1 to 1.4). RESULTS: Clinical prediction rules were identified at 4, 8 and 12 months after discharge, and validated. Amputation levels above transtibial and mobility-aid use were common predictors for all three time frames. At 4 months, if four out of five predictor variables were present (LR+ = 43.9, 95% CI 2.73 to 999+), the probability of non-use increased from 12 to 86% (p<0.001). At 8 months, if all three predictor variables were present (LR+ = 33.9, 95% CI 2.1 to 999+), the probability of non-use increased from 15 to 86% (p<0.001). At 12 months, if two out of three predictor variables were present (LR+=2.8, 95% CI 0.9 to 6.6), the probability of non-use increased from 17 to 36% (p<0.031). CONCLUSIONS: These validated clinical prediction rules have implications for rehabilitation and service model development. [Roffman CE, Buchanan J, Allison GT (2014) Predictors of non-use of prostheses by people with lower limb amputation after discharge from rehabilitation: development and validation of clinical prediction rules.Journal of Physiotherapy60: 224-231]. Crown
QUESTIONS: Can rules be developed to predict the risk of non-use of prostheses by people with lower limb amputation following discharge from rehabilitation? Are these clinical prediction rules valid? DESIGN: Retrospective and prospective cohort study designs. PARTICIPANTS: Consecutive tertiary rehabilitation patients: 135 retrospective (103 males, mean age = 56 years, SD 15) and 66 prospective (58 males, mean age = 54 years, SD 16). METHOD: Medical records were audited for potential predictor variables. Retrospective participants were interviewed at a median of 1.9 years after discharge (IQR 1.4 to 2.5) and prospective participants at a median of 1.3 years (IQR 1.1 to 1.4). RESULTS: Clinical prediction rules were identified at 4, 8 and 12 months after discharge, and validated. Amputation levels above transtibial and mobility-aid use were common predictors for all three time frames. At 4 months, if four out of five predictor variables were present (LR+ = 43.9, 95% CI 2.73 to 999+), the probability of non-use increased from 12 to 86% (p<0.001). At 8 months, if all three predictor variables were present (LR+ = 33.9, 95% CI 2.1 to 999+), the probability of non-use increased from 15 to 86% (p<0.001). At 12 months, if two out of three predictor variables were present (LR+=2.8, 95% CI 0.9 to 6.6), the probability of non-use increased from 17 to 36% (p<0.031). CONCLUSIONS: These validated clinical prediction rules have implications for rehabilitation and service model development. [Roffman CE, Buchanan J, Allison GT (2014) Predictors of non-use of prostheses by people with lower limb amputation after discharge from rehabilitation: development and validation of clinical prediction rules.Journal of Physiotherapy60: 224-231]. Crown
Authors: Andrea Cimolato; Josephus J M Driessen; Leonardo S Mattos; Elena De Momi; Matteo Laffranchi; Lorenzo De Michieli Journal: J Neuroeng Rehabil Date: 2022-05-07 Impact factor: 5.208