Functional Outcomes of Prosthetic Rehabilitation in Lower Limb Amputees: Retrospective Cohort Study

Abstract

Background:
Lower limb amputation leads to significant physical disability and long-term functional challenges, requiring comprehensive prosthetic rehabilitation to restore mobility and independence. Functional outcomes following prosthetic rehabilitation vary widely and are influenced by factors such as level of amputation, rehabilitation duration, and clinical support. In Pakistan, particularly within armed forces rehabilitation centers, evidence describing real-world functional outcomes of amputee rehabilitation remains limited.

Objective:
To evaluate the functional outcomes of prosthetic rehabilitation in lower limb amputees treated at armed forces rehabilitation centers in Rawalpindi.

Methods:
A retrospective cohort study was conducted using medical records of 140 adult lower limb amputees who completed prosthetic rehabilitation between 2021 and 2022. Data were obtained from armed forces rehabilitation facilities in Rawalpindi. Functional outcomes were assessed using the Locomotor Capability Index, Functional Independence Measure mobility subscale, 6-Minute Walk Test, and Timed Up and Go test. Comparative analysis was performed based on level of amputation. Statistical analysis included descriptive statistics, independent sample t-tests, one-way analysis of variance, and Pearson correlation analysis.

Results:
The mean Locomotor Capability Index score was 31.4 ± 6.8, and the mean Functional Independence Measure mobility score was 79.2 ± 12.5. The average 6-Minute Walk Test distance was 342.6 ± 78.9 meters, and the mean Timed Up and Go time was 14.8 ± 3.9 seconds. Transtibial amputees demonstrated significantly better functional outcomes than transfemoral amputees across all measures (p < 0.001). Independent community ambulation was achieved by 55.7% of participants. Rehabilitation duration showed a moderate positive correlation with locomotor capability (r = 0.46, p < 0.001).

Conclusion:
Prosthetic rehabilitation in specialized armed forces centers was associated with meaningful functional recovery in lower limb amputees. Improved mobility and independence were particularly evident among transtibial amputees, emphasizing the importance of structured and sustained rehabilitation programs.

Keywords
Amputation; Gait; Mobility Limitation; Physical Rehabilitation; Prostheses and Implants; Prosthetic Rehabilitation; Walking