Factors related to successful job reintegration of people with a lower limb amputation

Schoppen, Tanneke; Boonstra, Albert; Groothoff, Johan W.; Sonderen, van Eric; Ln, Göeken; Eisma, W.H.

doi:10.1053/apmr.2001.26074

Cited by 82 publications

(64 citation statements)

References 17 publications

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“…6,9, 16,17,19, 20 Studies have shown that quality of life and return to work in the amputee population is strongly influenced by mobility (including prosthesis acquisition and prosthesis use), physical function and general activity level. 15–16,33–34 Additionally, improved physical independence has been shown to be correlated with survival 19 , further highlighting the importance of optimization of functional outcomes during the rehabilitation process for amputee patients.…”

Section: Discussionmentioning

confidence: 99%

Functional Outcomes of Persons Who Underwent Dysvascular Lower Extremity Amputations

Sauter

Pezzin

Dillingham

2013

American Journal of Physical Medicine &Amp; Rehabilitation

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Objective-To examine the effect of post-acute rehabilitation setting on functional outcomes among patients undergoing major lower extremity dysvascular amputations.Design-A population-based, prospective cohort study conducted in Maryland and Wisconsin. Data collected from medical records and patient interviews conducted during acute hospitalization following amputation and at six-month following the acute care discharge were analyzed using multivariate models and instrumental variable techniques.Results-A total of 297 patients were analyzed based on post-acute care rehabilitation setting: acute inpatient rehabilitation (IRF), skilled nursing facility (SNF) or home. The majority (43.4%) received care in IRF, 32% in SNF, and 24.6% at home. On SF-36 subscales, significantly improved outcomes were observed for patients receiving post-acute care at an IRF relative to those cared for at a SNF in physical function (PF), role physical (RF) and physical component score (PCS). Patients receiving post-acute care in IRFs also experienced better RF and PCS outcomes compared to those discharged directly home. In addition, patients receiving post-acute care at an IRF were significantly more likely to score in the top quartile for general health in IRF compared to SNF or home, and less likely to score in the lowest quartile for PF, RF and PCS in IRF compared to SNF. Lower ADL impairment was observed in IRF compared to SNF.Conclusions-Among this large and diverse cohort of patients undergoing major dysvascular lower limb amputations, receipt of interdisciplinary rehabilitation services at an IRF yielded improved functional outcomes six months after amputation relative to care received at SNFs or home.Correspondence: Timothy R. Dillingham, MD, MS, Department of Physical Medicine and Rehabilitation, University of Pennsylvania, 1800 Lombard Street, First Floor, Philadelphia, PA 19046. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Disclosures:Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article. NIH Public Access Author ManuscriptAm J Phys Med Rehabil. Author manuscript; available in PMC 2014 April 01. Currently, the incidence of limb loss secondary to dysvascular etiology accounts for the majority (82%) of amputations in the United States 1 and the incidence of such amputations is expected to rise with climbing rates of co-morbid diseases such as peripheral vascular disease and diabetes. 2 The prevalence of dysvascular lower extremity amputations (i.e. nontr...

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Section: Discussionmentioning

confidence: 99%

Functional Outcomes of Persons Who Underwent Dysvascular Lower Extremity Amputations

Sauter

Pezzin

Dillingham

2013

American Journal of Physical Medicine &Amp; Rehabilitation

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“…Previous studies also found that higher levels of anxiety and depression can constitute a predictable factor when dealing with people with MSDs (27,28). Lower occupational competence of the participants in the current study was expected since most of them (58%) had experienced lower limb or trunk injuries, which are associated with impaired mobility, and reduced sitting and standing tolerance (29)(30)(31)(32). Many participants worked in physically demanding jobs such as factory labourers, lorry drivers, or dispatch riders.…”

Section: Discussionmentioning

confidence: 81%

Occupational competence and its relationship to emotional health in injured workers in return to work programs: A Malaysian study

Murad

O’Brien

Farnworth

et al. 2012

Scandinavian Journal of Occupational Therapy

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Workers with musculoskeletal disorders undertaking Malaysia's return to work (RTW) programmes may experience challenges in occupational competence (OC) and negative emotional states (NES). This study aimed to measure and examines the OC and NES of the workers by comparing specific comparison groups and groups of different phases. A total of 76 participants were recruited from a national RTW programme and categorized into three groups based on different RTW phases: off-work (n = 22), re-entry (n = 31), and maintenance (n = 23). Self-report questionnaires consisted of the Occupational Self Assessment version 2.2 and the Depression, Anxiety and Stress Scale-21. Results showed that injured workers exhibited significantly lower OC in comparison with an international group with various disabilities. In contrast, there was significantly higher NES when compared with Malaysia's general population. Significant differences in OC and NES were also found between workers in the three RTW phases. In particular, OC and NES in the off-work and re-entry phases were significantly lower (OC) and higher (NES) than in the maintenance phase. Furthermore, there was a moderate, negative correlation between OC and NES in the off-work and re-entry phase groups. This indicated that low levels of perceived OC were associated with higher levels of NES.

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“…Amputees with chronic pain report significantly more performance difficulties and disability than persons without pain (Marshall et al 1992) but not psychological distress or negative affect (Whyte and Niven 2001). In addition, over 50% of those with PLP report having residual limb pain (also known as stump pain), which impairs function and is negatively correlated with employment (Schoppen et al 2001;Sherman and Sherman 1983;Whyte and Carroll 2002). Gallagher et al (2001) report that amputees with residual limb pain experience greater levels of pain intensity and greater interference with daily activities than amputees with PLP.…”

Section: Psychological Factors Affecting Phantom Limb Painmentioning

confidence: 99%

Management of Phantom Limb Pain

MacIver

Lloyd²

2009

Amputation, Prosthesis Use, and Phantom Limb Pain

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This chapter provides a comprehensive overview of the management of chronic phantom limb pain (PLP) as it relates to the patient in the prosthesis clinic. The chapter begins with phantom pain assessment. Pharmacological therapies commonly used in the treatment of PLP will be discussed, with a review of the literature relating to success or otherwise of these medications. The side-effects of the drugs are highlighted, and the necessary advice to be given to patients is provided. What follows is a review of non-pharmacological therapies, beginning with Neuromodulation (TENS, spinal cord and deep brain stimulation). Psychological aspects of treatment are identified -how to recognise psychological distress; how to know when to refer on for psychological treatment and useful psychological interventions. The chapter concludes with suggestions for the holistic management of patients suffering from PLP. The role of mental imagery is highlighted.

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Factors related to successful job reintegration of people with a lower limb amputation

Cited by 82 publications

References 17 publications

Functional Outcomes of Persons Who Underwent Dysvascular Lower Extremity Amputations

Functional Outcomes of Persons Who Underwent Dysvascular Lower Extremity Amputations

Occupational competence and its relationship to emotional health in injured workers in return to work programs: A Malaysian study

Management of Phantom Limb Pain

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