Evaluation of short-term functional mobility outcomes in patients with traumatic lower limb amputations: A prospective cohort study in India

Background: Traumatic amputation of the lower limb is a significant life-changing event. It is associated with substantial functional disability.

Objective: To assess the serial improvement in functional mobility outcomes after the rehabilitation provided to traumatic unilateral lower limb amputee (TULLA) over 6 months of follow-up.

Methods: It is a prospective observational cohort study including 106 TULLA performed in a tertiary care trauma center in North India from January 2021 to December 2021. Patients were followed up at 2 weeks, 3 months and 6 months post-surgery in the focused amputee clinic, where functional mobility care was provided by physical rehabilitation and prosthesis application and patients were evaluated using the Locomotors Capabilities Index (LCI-5) and L-Test of functional mobility.

Results: There was a significant improvement in LCI-5 and L-Test from discharge to follow-up. The mean overall LCI-5 scores were 14.68 ± 6.56, 28.29 ± 9.04 and 42.77 ± 8.94 at 2 weeks, 3 months and 6 months respectively. The mean L-test for overall individuals with limb loss (N = 100) at discharge, 2 weeks, 3 months and 6 months were 178.41 ± 49.62, 126.98 ± 37.76, 98.39 ± 30.09 and 72.82 ± 21.03 respectively. Further, a subgroup analysis showed a significant improvement in LCI-5 and L-test in individuals with above-knee and below-knee limb loss with prostheses compared to those without prostheses.

Conclusion: Our multidisciplinary approach helps to improve functional mobility outcomes among TULLA. Focused amputee clinics are the need of the hour to achieve successful functional mobility following amputation.