Use the Back button in your browser to see the other results of your search or to select another record.

Detailed Search Results

Hull early walking aid for rehabilitation of transtibial amputees -- randomized controlled trial (HEART)
Mazari FA, Mockford K, Barnett C, Khan JA, Brown B, Smith L, Polman RC, Hancock A, Vanicek NK, Chetter IC
Journal of Vascular Surgery 2010 Dec;52(6):1564-1571
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

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 = 0.020) faster in the PPAMA group (0.245 m/s, interquartile range (IQR) 0.218 to 0.402 m/s) compared with the AMA group (0.165 m/s; IQR 0.118 to 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 = 0.045) lower in the PPAMA group (5.0; IQR 3.5 to 8.0) compared with the AMA group (6.0; IQR 6.0 to 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 = 0.001; PPAMA p = 0.007); 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 = 0.037; PPAMA p = 0.029). CONCLUSIONS: There is no difference in clinical and QOL outcomes between articulated and nonarticulated EWAs in rehabilitation of transtibial amputees.

Full text (sometimes free) may be available at these link(s):      help