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Amputee Mobility Predictor - Physiopedia

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The Amputee Mobility Predictor: An instrument to assess determinants of the lower-limb ..

WBC count, 216 glucose level
- Vascular team diagnoses gangrene
- OR for open TMT amputation
HPI Continued...
Poor blood flow to incision site post-TMT amputation
7/17: Popliteal Artery to distal Anterior Tibial Artery Reverse Vein Bypass
Bypass successful, but foot deemed non-viable
7/22: Standard Transtibial Below-Knee Amputation
Corinne Pro, SPT
Daemen College
Discharge to Sunnyview 7/24
Pt fitted with shrinker
Prescribed and educated on the use of insulin for diabetes control
116 Glucose level
Amputation Statistics
Currently 1.7 Million people in the US
Major causes:
- 70% Vascular disease
- 22% Trauma (MVA, farming)
- 4% Malignancy
- 4% Congenital Anomaly
75% occur in later years of life (55 and on)
-82% due to vascular disease (half of this is diabetes)
3 year survival rate with diabetes and lower limb amputation is 50%
Diabetes Statistics
18.8 million people in the US with diagnosed diabetes
7 million undiagnosed
Immediate Post-Operative PT Intervention for Lower Extremity Amputees
- Proper bed positioning
- Stretching
- Strengthening
Positioning to Prevent Contracture
AVOID
** Gentle
** 30 seconds per stretch
Stretching
- Prone hip flexor stretch
- Supine hamstring stretch

Strengthening
- Isometrics (glute/quad sets)
-Gentle exercise against gravity to patient tolerance (variable range)
-PRE to uninvolved limb as tolerated
-Upper extremity strength (chair dips)
Functional Outcome Measures
FIM
AMPnoPRO
AM-PAC
Functional Independence Measure (FIM)
Developed in 1983
18 items, motor and cognitive subscales
Intended populations:
-Geriatrics, MS, Stroke, SCI, General Pain
Use in amputee population
- Total FIM score is not useful for predicting prosthetic use and success for future rehab (Leung EC, Rush PJ, Devlin M, 2006)
- Motor subscale score is highly predictive of successful prosthetic rehab (Leung EC, Rush PJ, Devlin M, 2006)
- Predictability higher in patients with fewer comorbidites (Muecke L, Shekar S, Dwyer D, Israel E, Flynn JP, 1992)
Drawbacks:
- Time consuming
- Cost
- Training
Amputee Mobility Predictor without Prosthesis
(AMPnoPRO)
20 Items, 38 possible points
Specifically designed to assess mobility without prosthesis and predict level of function with prosthesis
15 minutes or less to complete
High interrater(.99)and intrarater(.97) reliability
Excellent tool for classification of patients into Medicare K-levels (classification system that determines the prosthetic components for which Medicare will pay)
Free to administer, no training necessary
(Gailey et al, 2002)
Activity Measure for Post-Acute Care
(AM-PAC)
Tool specifically designed for use in all rehab settings
- Allows for continued assessment as patient is transferred between settings
269 Items divided into 3 subscales: basic mobility (131), daily activities (88), and cognition (50)
CAT Software
Short forms for quicker testing
More sensitive to change than the FIM (Coster et al, 2006)
Appropriate for a variety of diagnoses- including amputees!
References
1.

PPT – Amputee Mobility Predictor PowerPoint …

The Amputee Mobility Predictor: an instrument to assess determinants of the lower-limb amputee’s ability to ambulate.

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The Amputee Mobility Predictor: An Instrument to …

A-0456 “Wrap it, bag it and dunk it”. Do frontline staff know how to appropriately store an amputated digit(s)?

The Amputee Mobility Predictor: An instrument to assess determinants of the lower-limb amputee's ..
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