Pain, functional status, social function and conditions of habitation in elderly unilateraly lower limb amputees.

Abstract

BACKGROUND/AIM: Few authors are involved in home rehabilitation of amputees or their reintegration into the community. It has been remarked that there is a discontinuity between the phases of the amputee rehabilitation in Serbia. The aim of the study was to establish pain characteristics and functional status of amputees two months after the amputation and to determine their social function and the conditions of their habitation. METHODS: This prospective observation study involved 38 elderly amputees with unilateral lower limb amputations. The patients were tested at the hospital on discharge and at their homes two months after the amputation. Pain intensity and functional status were measured by a visual analogue scale (VAS) and by Functional Independence Measure (FIM). The patients' social function was assessed using the Social Dysfunction Rating Scale (SDRS) and conditions of their habitation by the self-created Scale of Conditions of Habitation (SCH). In statistic analysis we used the Student t test, chi2 test and Analysis of variance (ANOVA). RESULTS: The majority of patients (63%) underwent below knee amputation caused by diabetes (89%). A significant number of patients (84%, chi2 = 17.78; p < 0.01) was not visited by a physiotherapist nor an occupational therapist during two months at home. In this period, the majority of the amputees (68%) had phantom pain or residual limb pain (21%). Two months after amputation the pain intensity was significantly lower (VAS = 4.07 +/- 2.19; 2.34 +/- 1.41; p < 0.001), and the functional status significantly better than on discharge (FIM = 75.13 +/- 16.52; 87.87 +/- 16.48; p < 0.001). The amputees had the average level of social dysfunction (SDRS = 62.00 +/- 11.68) and conditions of habitation (SCH = 7.81 +/- 1.97). CONCLUSION: A total 38 elderly amputees with unilateral lower limb amputations achieved significant functional improvement and reduction of pain, in spite of their social dysfunction, the absence of socio-medical support and inadequacy of the conditions of habitation.