The influence of prior stroke on the prosthetic rehabilitation of lower limb amputees

Concurrent stroke is believed to have an adverse influence on the process a nd outcome of prosthetic rehabilitation, but there is limited published evi dence for this. The aim of this study was to establish a clearer picture in order to assist decision making for both patients and professionals. Demographic and clinical data were collected from all lower limb amputees r eferred from North and West Yorkshire for prosthetic rehabilitation. Additi onal data were collected from all new lower limb amputees in three of the r eferring health districts, irrespective of prosthetic referral. Patients with prior stroke were less likely to be referred for prosthetic r ehabilitation. Improved mobility and independence were seen following prost hetic rehabilitation irrespective of prior stroke. The group with prior str oke compared well with the non-stroke group in terms of walking aid usage, but a smaller proportion of the stroke group were able to walk 30m without stopping and there were trends for smaller gains in independence in the str oke group. Nevertheless, this study demonstrates that prosthetic rehabilitation can be successful in a selected amputee population with prior stroke. In those wh o continue prosthetic use for one year, outcome is similar to that in patie nts without stroke.