Cc. Chiu et al., Influencing factors and ambulation outcome in patients with dual disabilities of hemiplegia and amputation, ARCH PHYS M, 81(1), 2000, pp. 14-17
Objective: To determine the ambulatory outcome and predictive factors of su
ccessful ambulation training in patients with both hemiplegia and lower ext
remity amputation.
Design: A retrospective study.
Setting: A rehabilitation center of a university hospital.
Patients: Twenty-three patients with dual disabilities consecutively admitt
ed to the rehabilitation center from 1984 to 1994.
Main Outcome Measures: Ambulatory outcome was measured using physical thera
pists' and physicians' notes at discharge or the last available clinical vi
sit. Ambulation ability was graded as community and noncommunity ambulation
, which included indoor ambulation and nonambulation. Several clinical feat
ures were reviewed to assess their association with ambulation outcome.
Results: About two thirds of the 23 patients could be trained to be ambulat
ory: 10 (43.8%) achieved community ambulation and 5 (21.7%) achieved indoor
ambulation. Of the clinical factors, only mental status showed a statistic
ally significant association with good ambulation outcome (p <.05). When od
ds ratios were considered,several factors, including mild motor involvement
, transtibial amputation, amputation before cerebrovascular accident, age y
ounger than 60 years, and the presence of ipsilateral hemiplegia and amputa
tion, showed trends toward association with increased ambulation achievemen
t, although these associations were not statistically significant.
Conclusion: Impaired mental status seemed to be the most influential negati
ve predictive factor of achieving community ambulation. If subjects with du
al disabilities are properly selected, satisfactory results of ambulation G
raining will be obtained.