FUNCTIONAL LIMITATIONS IN PATIENTS WITH DIABETES AND TRANSMETATARSAL AMPUTATIONS

Background and Purpose. Reports in the surgical and rehabilitation lit erature suggest that patients with transmetatarsal amputations (TMAs) function well with regular shoes and a toe filler. Functional limitati ons, however,have not been documented in this population. The purpose of this study was to compare the function of patients with diabetes me llitus (DM) and TMA with that of age-and gender-matched control subjec ts. Subjects. Thirty subjects (15 subjects with DM and TMAs and 15 con trol subjects), with a mean age of 62.3 years (SD=9.2, range=43-83), w ere studied. Methods. Function was measured using the Functional Reach Test (FRT), the Physical Performance Test (PPT), walking speed for 15 .2 m (50 ft), and the Sickness Impact Profile (SIP). Subjects in the T MA-DM group wore standard shoes with a toe filler. Results. The TMA-DM . group scored lower (mean +/- standard deviation) than did the contro l group on all tests (FRT: 19.1 +/- 8.6 vs 31.5 +/- 9.1 cm [7.5 +/- 3. 4 vs 12.4 +/- 3.6 in]; PPT: 18.7 +/- 4.8 vs 24.1 +/- 2.2 points [28 po ints possible]; walking speed: 51.5 +/- 13.2 vs 75.6 +/- 9.3 m/min; SI P: 17.0 +/- 12.7 vs 3.7 +/- 4.7). Conclusion and Discussion. Persons w ith DM and TMAs have considerable functional limitations. Research is needed to determine whether therapeutic footwear or other forms of reh abilitation can improve their function.