Exploring the Effect of Preamputation Employment and Income on Ambulation in Dysvascular Lower Extremity Amputees After Amputee Rehabilitation: A Retrospective Cohort Study

Abstract

Objective

To assess the relationship between 2-minute walk test (2MWT) distance, employment status, and median household income in adult dysvascular amputee patients after a 6-week rehabilitation program.

Design

Retrospective cohort study.

Setting

Amputation rehabilitation program.

Participants

In total, 505 patients were included in the analysis. Most (71.1%) were men and had below-knee amputations (78.3%); the average age was 65.3±11.6 years.

Interventions

Not applicable.

Main Outcome Measures

2MWT distance at discharge.

Results

Men (68.3±32.6m) and below-knee amputation amputees (70.9±32.0m) walked significantly further than women (58.8±30.0m; P=.003) and above-knee amputees (47.2±25.7m; P<.001), respectively. A significant negative correlation was found between 2MWT distance and age (r=−.32; P<.001) as well as time from consultation to admission (r=−.23; P<.001). An unadjusted general linear model (GLM) revealed that employment status (F_2,446=17.47; P<.001) but not income (F_4,446=.714; P=.58) was statistically significantly associated with 2MWT distance. An adjusted (age, sex, time from consult to admission, and amputation level) GLM revealed employment status remained significant (F_2,434=5.59; P=.004) and income remained insignificant (F_4,434=.43; P=.784). Differences in 2MWT distance between employment and income groups did not meet clinical significance.

Conclusions

Preamputation employment appears to be associated with postrehabilitation outcomes.