Cochrane: Problems with inadequate circulation in the legs (dysvascularity), particularly in people over the age of 60 years, can be so severe that they need a leg amputated. This may be as high as at or above the knee. Accompanying medical conditions (co-morbidities) such as diabetes, cardiovascular or heart disease can affect a person's rehabilitation. When an above or through knee artificial limb (prosthesis) is fitted, it is hard to regain mobility and function and some people choose to use a wheelchair.
Motivation, comfort, cosmetic appearance, functionality, reliability, ease of use, previous mobility and the extra exertion needed to use an artificial leg are all potentially important factors that affect a person's independence and their use of the prosthesis. Fear of falling, number of falls, social circumstances, help and support from other people are also important influences. The review authors searched for trials comparing different types of rehabilitation that may benefit the mobility or function in older people using an artificial limb.
Only one controlled trial was found. This had a crossover design and each of the 10 participants had three seemingly identical prosthetic weights added to the prosthesis below the knee in a random order. The participants, nine men and one woman, were over 50 years of age and eight were over 60 years. Over the few hours of the trial, four participants preferred the lightest weight (150 g), five preferred the medium weight (770 g) and one preferred the heaviest weight (1625 g). Seven of the 10 people successfully ranked the weights from lightest to heaviest. The weights did not alter the participant's walking speed in a two-minute walk test.
The small number of participants, short exposure to the different weights in a laboratory setting and the fact that there were differences in weight between people and also their prosthesis limits the usefulness of these findings. The artificial limbs were all modular style prostheses.
- See more at: http://summaries.cochrane.org/CD005260/PVD_artificial-limb-rehabilitation-for-older-people-with-a-leg-amputated-at-or-above-the-knee-because-of-blood-circulation-problems#sthash.0WHwwhmn.dpuf