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Arch Phys Med Rehabil. 2003 Jun;84(6):803-11.

Physical, mental, and social predictors of functional outcome in unilateral lower-limb amputees.

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Department of Rehabilitation Medicine, University Hospital Groningen, The Netherlands.



To study the value of physical, mental, and social characteristics as predictors of functional outcome of elderly amputees.


Prospective, inception cohort study; comparisons with reference populations.


Main hospitals, rehabilitation centers, nursing homes, patients' own residence settings in 1 of the 3 northern provinces in the Netherlands.


Forty-six patients older than 60 years, with unilateral transtibial or transfemoral amputation or knee disarticulation because of vascular disease.


Measurement of physical, mental, and social predictors 2 and 6 weeks postamputation.


The Sickness Impact Profile (SIP-68), Groningen Activity Restriction Scale (GARS), Timed up and go (TUG) test, and prosthetic use.


A total of 15% of amputees died within the first year after amputation. Seventy percent lived independently at home 1 year postamputation. The functional level of the patients was low, as shown by high scores on the SIP-68 (mean, 23.6), GARS (mean, 41.2), and TUG test (mean, 23.9s). Functionally effective prosthetic use, as measured with the classification of Narang and Pohjolainen, was reached by 49%. For the SIP-68 scores, age, comorbidity, 1-leg balance, and the 15-word test predicted functional outcome in 69% of amputees. For the GARS score, age, 1-leg balance, and the 15-word test predicted functional outcome in 64%. For the TUG test, age and 1-leg balance predicted functional outcome in 42% of amputees. After correction for age, the only significant predictor for prosthetic use was 1-leg balance.


Elderly patients with a leg amputation had a low functional level 1-year postamputation. An important part of functional outcome could be predicted 2 weeks after amputation by age at amputation, 1-leg balance on the unaffected limb, and cognitive impairment. Severe comorbidity probably also played a role. The results may be used in the general policy concerning leg amputees.

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