Abstract
Objective: To assess if evidence of disparities exists in functional recovery and social health post-lower limb amputation. Design: Race-ethnicity, gender, and income-based group comparisons of functioning and social health in a convenience sample of lower limb prosthetic users. Setting: Prosthetic clinics in 4 states. Participants: A geographically diverse cohort of 56 English and Spanish speaking community-dwelling individuals with dysvascular lower limb amputation, between 18-80 years old. Interventions: None. Main Outcomes Measures: Primary outcomes included 2 physical performance measures, the Timed Up and Go test and 2-minute walk test, and thirdly, the Prosthetic Limb Users Survey of Mobility. The PROMIS Ability to Participate in Social Roles and Activities survey measured social health. Results: Of the study participants, 45% identified as persons of color, and 39% were women (mean ± SD age, 61.6 (9.8) years). People identifying as non-Hispanic White men exhibited better physical performance than men of color, White women, and women of color by -7.86 (95% CI, -16.26 to 0.53, P=.07), -10.34 (95% CI, -19.23 to –1.45, P=.02), and -11.63 (95% CI, -21.61 to –1.66, P=.02) seconds, respectively, on the TUG, and by 22.6 (95% CI, -2.31 to 47.50, P=.09), 38.92 (95% CI, 12.53 to 65.30, P<.01), 47.53 (95% CI, 17.93 to 77.13, P<.01) meters, respectively, on the 2-minute walk test. Income level explained 14% and 11% of the variance in perceived mobility and social health measures, respectively. Conclusions: Study results suggest that sociodemographic factors of race-ethnicity, gender, and income level are associated with functioning and social health post-lower limb amputation. The clinical effect of this new knowledge lies in what it offers to health care practitioners who treat this patient population, in recognizing potential barriers to optimal recovery and quality of life. More work is required to assess lived experiences after amputation and provide better understanding of amputation-related health disparities.
| Original language | English |
|---|---|
| Pages (from-to) | 208-216 |
| Number of pages | 9 |
| Journal | Archives of Physical Medicine and Rehabilitation |
| Volume | 105 |
| Issue number | 2 |
| DOIs | |
| State | Published - Feb 2024 |
Bibliographical note
Publisher Copyright:© 2023
Funding
This research was supported in part by the National Institute on Minority Health and Health Disparities of the National Institutes of Health Under Award Number NIMHD ( U54MD012393 ), Florida International University Research Center in Minority Institutions. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Additional funding was provided by the Center for Orthotic and Prosthetic Learning and Outcomes/Evidence-based Practice and the American Orthotic and Prosthetic Association. The funding organization had no role in the design and conduct of the study; collection, management, analysis, or interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
| Funders | Funder number |
|---|---|
| American Orthotic and Prosthetic Association | |
| National Institutes of Health (NIH) | |
| National Institute on Minority Health and Health Disparities (NIMHD) | U54MD012393 |
| Florida International University |
Keywords
- Amputation
- Functional performance
- Health disparity populations
- Rehabilitation
ASJC Scopus subject areas
- Physical Therapy, Sports Therapy and Rehabilitation
- Rehabilitation