Defining successful mobility after lower extremity amputation for complications of peripheral vascular disease and diabetes

BackgroundInformation about longer-term functional outcomes following lower extremity amputation for peripheral vascular disease and diabetes remains limited. This study examined factors associated with mobility success during the first year following amputation.MethodsProspective cohort study of 87 amputees experiencing a first major unilateral amputation surgery. Seventy-five (86%) participants completed 12-month follow-up interview.ResultsTwenty-eight subjects (37%) achieved mobility success, defined as returning to or exceeding a baseline level of mobility on the locomotor capability index (LCI-5). Forty-three subjects (57%) were satisfied with their mobility. Individuals who were 65 years of age and older (risk difference [RD] = −0.52; 95% confidence interval [CI]: −0.75, −0.29), reported a current alcohol use disorder (RD = −0.37; 95% CI: −0.48, −0.26), had a history of hypertension (RD = −0.23; 95% CI: −0.43, −0.03) or treatment for anxiety or depression (RD = −0.39; 95% CI: −0.50, −0.28) were less likely to achieve mobility success. Mobility success was associated with mobility satisfaction (RD = 0.36; 95% CI: 0.20, 0.53) and satisfaction with life (RD = 0.28; 95% CI: 0.06, 0.50). Although higher absolute mobility at 12 months was also associated with mobility satisfaction and overall life satisfaction, 50% of individuals who achieved success with low to moderate 12-month mobility function reported they were satisfied with their mobility.ConclusionDefining success after amputation in relation to an individual's specific mobility prior to the development of limb impairment which led to amputation provides a useful, patient-centered measure that takes other aspects of health, function, and impairment into account.