The influence of prior stroke on the prosthetic rehabilitation of lower limb amputees

Concurrent stroke is believed to have an adverse influence on the process and outcome of prosthetic rehabilitation, but there is limited published evidence for this. The aim of this study was to establish a clearer picture in order to assist decision making for both patients and professionals. Demographic and clinical data were collected from all lower limb amputees referred from North and West Yorkshire for prosthetic rehabilitation. Additional data were collected from all new lower limb amputees in three of the referring health districts, irrespective of prosthetic referral. Patients with prior stroke were less likely to be referred for prosthetic rehabilitation. Improved mobility and independence were seen following prosthetic rehabilitation irrespective of prior stroke. The group with prior stroke compared well with the non-stroke group in terms of walking aid usage, but a smaller proportion of the stroke group were able to walk 30m without stopping and there were trends for smaller gains in independence in the stroke group. Nevertheless, this study demonstrates that prosthetic rehabilitation can be successful in a selected amputee population with prior stroke. In those who continue prosthetic use for one year, outcome is similar to that in patients without stroke.