Arbuckle

Belch

Bouch

Broomhead

C. Seenan

Chen

Cohen

Cutson

Czerniecki

Davie-Smith

Dawson

Dillingham

Evans

F. Davie-Smith

Fortington

Greenhalgh

H. Scott

Hankey

Health and Social Care Information Centre

Hordacre

J. Hebenton

Johannesson

Moxey

Pashikanti

Pezzin

Sanders

Sauter

Schuyler Jones

Scott

Smith

Taylor

Turney

English

Crossref

Relationship between models of care and key rehabilitation milestones following unilateral transtibial amputation: a national cross-sectional study

Objectives: Identify different models of care (MOC) post Trans-Tibial Amputation (TTA) and relate these to achievement of rehabilitation milestones.Design: Retrospective analysis of rehabilitation milestone data and a survey of MOC in ten vascular centres.Setting: NHS Scotland Vascular Centres.Participants: All unilateral TTA between January 2011 and December 2014 (n = 643).Main outcome measures: The time to achieve the rehabilitation milestones: compression therapy, early walking aid, casting for a prosthetic limb, prosthetic delivery, in-patient discharge and final discharge from rehabilitation. MOC were scored according to seven key aspects of service provision.Results: Mean age of the cohort was 66.7 (±=12.5) years, 75.9% males and 62.8% had peripheral arterial disease with diabetes. Mean days to achieve rehabilitation milestones varied across centres: compression therapy (11.9 (±24.9); early walking aid (27.6 (±36.4); prosthetic casting 60.2 (±57.5); prosthetic delivery 73.8 (±59.8), in-patient discharge 67.6 (±54.8) and final discharge from rehabilitation 166.1 (±100.6). Only two centres included all seven key aspects of service provision within their MOC. Vascular centres who achieved the optimal MOC also achieved their rehabilitation milestones the quickest.Conclusions: This study demonstrated a positive association between optimal MOC and early achievement of rehabilitation milestones post TTA. Key aspects of service provision associated with a quicker time to achieve rehabilitation milestones included: use of a post-operative rigid dressing; specialist physiotherapy input in the early post-operative period; daily in-patient gym sessions and in-patient prosthetic provision. This study is the first to document the MOC following TTA relating these to the achievement of rehabilitation milestones

Hebenton, Joanne

Scott, Helen

Seenan, Chris

Davie-Smith, Fiona

ResearchOnline@GCU

https://researchonline.gcu.ac.uk/files/26937936/Hebenton_et_al_2018_MOC_post_amputation.pdf

Relationship between models of care and key rehabilitation milestones following unilateral transtibial amputation: a national cross-sectional study

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ResearchOnline@GCU