Hull early walking aid for rehabilitation of transtibial amputees - randomized controlled trial (HEART)

Vanicek, Natalie K.; Mazari, Fayyaz Ali Khan; Mockford, Katherine; Vanicek, Natalie; Barnett, Cleveland; Khan, Junaid A.; Brown, Barbara; Smith, Lynne; Polman, Remco C.; Hancock, Amanda; Chetter, Ian C.

Abstract

Purpose: To compare articulated and nonarticulated early walking aids (EWAs) for clinical and quality-of-life outcomes in transtibial amputees. Methods: Patients undergoing lower limb amputation in a tertiary-care vascular surgical unit were screened over a 4-year period. Recruited patients were randomized to receive articulated amputee mobility aid (AMA) or nonarticulated pneumatic postamputation mobility aid (PPAMA) during early rehabilitation. Primary (10-meter walking velocity) and secondary clinical (number and duration of physiotherapy treatments during EWA/prosthesis use) and quality-of-life (SF-36) outcome measures were recorded at five standardized assessment visits. Inter-group and intra-group analyses were performed. Results: Two hundred seventy-two patients were screened and 29 transtibial amputees (median age, 56 years) were recruited (14/treatment arm). No significant difference was seen in demographics and comorbidities at baseline. Inter-group analysis: Median 10-meter walking velocity was significantly (Mann-Whitney, P = .020) faster in the PPAMA group (0.245 m/s, interquartile range [IQR] 0.218-0.402 m/s) compared with the AMA group (0.165 m/s; IQR, 0.118-0.265 m/s) at visit 1. However, there was no difference between the groups at any other visit. Similarly, the number of treatments using EWA was significantly (P = .045) lower in the PPAMA group (5.0; IQR, 3.5-8.0) compared with the AMA group (6.0; IQR, 6.0-10.5). No difference was observed between the groups in duration of physiotherapy or SF-36 domain and summary scores. Intra-group analysis: Both treatment groups showed significant improvement in 10-meter walking velocity (Friedman test; AMA P = .001; PPAMA P = .007); however, other clinical outcomes did not show any statistically significant improvement. Only physical function domain of SF-36 demonstrated significant improvement (Friedman test; AMA P = .037; PPAMA P = .029). Conclusions: There is no difference in clinical and QOL outcomes between articulated and nonarticulated EWAs in rehabilitation of transtibial amputees. (J Vase Surg 2010;52:1564-71.)

Citation

Mazari, F. A. K., Mockford, K., Vanicek, N., Barnett, C., Khan, J. A., Brown, B., Smith, L., Polman, R. C., Hancock, A., & Chetter, I. C. (2010). Hull early walking aid for rehabilitation of transtibial amputees - randomized controlled trial (HEART). Journal of vascular surgery, 52(6), 1564-1571. https://doi.org/10.1016/j.jvs.2010.07.006

• Journal Article Type: Article
• Acceptance Date: Jul 12, 2010
• Online Publication Date: Sep 19, 2010
• Publication Date: 2010-12
• Deposit Date: Nov 13, 2014
• Journal: Journal Of Vascular Surgery
• Print ISSN: 0741-5214
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 52
• Issue: 6
• Pages: 1564-1571
• DOI: https://doi.org/10.1016/j.jvs.2010.07.006
• Keywords: Surgery; Cardiology and Cardiovascular Medicine
• Public URL: https://hull-repository.worktribe.com/output/462644
• Contract Date: Nov 13, 2014