Department of Physical Therapy, Florida International University, Miami, FL.
Department of Preventive Medicine, Northwestern University, Chicago, IL.
Arch Phys Med Rehabil. 2024 Feb;105(2):208-216. doi: 10.1016/j.apmr.2023.10.003. Epub 2023 Oct 20.
To assess if evidence of disparities exists in functional recovery and social health post-lower limb amputation.
Race-ethnicity, gender, and income-based group comparisons of functioning and social health in a convenience sample of lower limb prosthetic users.
Prosthetic clinics in 4 states.
A geographically diverse cohort of 56 English and Spanish speaking community-dwelling individuals with dysvascular lower limb amputation, between 18-80 years old.
None.
Primary outcomes included 2 physical performance measures, the Timed Up and Go test and 2-minute walk test, and thirdly, the Prosthetic Limb Users Survey of Mobility. The PROMIS Ability to Participate in Social Roles and Activities survey measured social health.
Of the study participants, 45% identified as persons of color, and 39% were women (mean ± SD age, 61.6 (9.8) years). People identifying as non-Hispanic White men exhibited better physical performance than men of color, White women, and women of color by -7.86 (95% CI, -16.26 to 0.53, P=.07), -10.34 (95% CI, -19.23 to -1.45, P=.02), and -11.63 (95% CI, -21.61 to -1.66, P=.02) seconds, respectively, on the TUG, and by 22.6 (95% CI, -2.31 to 47.50, P=.09), 38.92 (95% CI, 12.53 to 65.30, P<.01), 47.53 (95% CI, 17.93 to 77.13, P<.01) meters, respectively, on the 2-minute walk test. Income level explained 14% and 11% of the variance in perceived mobility and social health measures, respectively.
Study results suggest that sociodemographic factors of race-ethnicity, gender, and income level are associated with functioning and social health post-lower limb amputation. The clinical effect of this new knowledge lies in what it offers to health care practitioners who treat this patient population, in recognizing potential barriers to optimal recovery and quality of life. More work is required to assess lived experiences after amputation and provide better understanding of amputation-related health disparities.
评估下肢截肢后功能恢复和社会健康方面是否存在差异。
在下肢假肢使用者的便利样本中，基于种族-民族、性别和收入的功能和社会健康组比较。
4 个州的假肢诊所。
一组地理上多样化的、年龄在 18-80 岁之间的、患有血管功能障碍的下肢截肢的、会讲英语和西班牙语的、社区居住的个体。
无。
主要结果包括 2 项身体表现测量，即计时起立行走测试和 2 分钟步行测试，以及第三项，假肢使用者移动性调查。PROMIS 参与社会角色和活动能力调查衡量社会健康。
在研究参与者中，45%的人是有色人种，39%是女性（平均±标准差年龄，61.6[9.8]岁）。与非西班牙裔白人男性相比，男性中的有色人种、白人女性和女性中的有色人种在 TUG 测试中分别慢了-7.86（95%置信区间，-16.26 至 0.53，P=.07）、-10.34（95%置信区间，-19.23 至 -1.45，P=.02）和-11.63（95%置信区间，-21.61 至 -1.66，P=.02）秒，在 2 分钟步行测试中分别慢了 22.6（95%置信区间，-2.31 至 47.50，P=.09）、38.92（95%置信区间，12.53 至 65.30，P<.01）和 47.53（95%置信区间，17.93 至 77.13，P<.01）米。收入水平分别解释了感知移动性和社会健康测量的 14%和 11%的方差。
研究结果表明，社会人口因素，包括种族-民族、性别和收入水平，与下肢截肢后的功能和社会健康有关。这方面新知识的临床意义在于，它为治疗这一患者群体的医疗保健从业者提供了什么，即认识到最佳康复和生活质量的潜在障碍。还需要进一步的工作来评估截肢后的生活经历，并更好地了解与截肢相关的健康差异。
