Physical therapy practice patterns for military service members with lower limb loss

Abstract

Introduction: Military service members with limb loss have unrestricted access to physical therapy(PT) services. Identifying PT interventions used based on clinical rationale and patient needs/goals can provide insighttowards developing best practice guidelines. The purpose of this study was to identify preferred PT practice patternsfor military service members with lower limb loss. Materials and Methods: This was a retrospective cohort study andwas approved by the Naval Health Research Center (NHRC) Institutional Review Board. Data for 495 service members with lower limb loss was analyzed. Frequency of PT visits and units of treatment received were quantified in 3-month increments during the first year after injury and compared for individuals with unilateral limb loss distal to theknee (DIST), unilateral limb loss proximal to the knee (PROX), and bilateral limb loss (BILAT). Results: A total of86,145 encounters occurred during the first year after injury. Active treatments were included in 94.0% of all treatments, followed by manual therapy (15.1%), patient education (11.5%) and modalities (2.4%). The highest number ofencounters, consisting of active and manual therapy, was received by the DIST group within the first 3 months, whileafter the first 3 months, the BILAT group had higher encounters and received more active and manual therapy.Utilization of patient education was higher in the PROX and BILAT groups compared to the DIST group throughoutthe first year after injury. Conclusions: Service members with limb loss utilize PT services often within the first yearafter injury. Trends of PT practice are most likely influenced by comorbidities and healing time variance betweenlevels of amputation.