Early PPAM aid use post-unilateral transtibial amputation is associated with reduced time to prosthetic fitting and finishing rehabilitation

Relevance: Pneumatic Post-Amputation Mobility aid (PPAM aid) use is commonly a key component of reha- bilitation following lower limb amputation. The effect of PPAM aid use on achievement of rehabilitation milestones is not established however. This study investigates the tim- ing of PPAM aid use post-unilateral transtibial amputation and the effects on rehabilitation milestones and outcomes. The findings have implications for research, education and practice. Purpose: The aim of this study is to investigate how the timing of PPAMaid use effects rehabilitation milestones and outcomes for patients following unilateral transtibial ampu- tation. Methods/analysis: Design: Mixed methods, retrospec- tive cross-sectional analysis of data from a national audit conducted by the Scottish Physiotherapy Amputee Research Group (SPARG). Participants: Data for all patients undergoing transtibial amputation in Scotland between 1st January 2011 and 31st December 2012 who used a PPAM aid during rehabilitation (n=323). Primary outcome measures: Days to reach key rehabil- itation milestones, Locomotor Capabilities Index 5 (LCI5) score and prosthetic fitting outcomes. Analysis: Collated and cleaned data was analysed using SPSS version 21. Due to high levels of variance within the data all participants with aetiologies other than Peripheral Arterial Disease (PAD) and/or diabetes were excluded from the analysis. The data for participants who used PPAM aid users were grouped into quintiles relating to the number of days to the first use of a PPAM aid. Demographic profile, outcomes and milestones were analysed for inter-group differences. Results: There was no difference in demographic data, pre-operative mobility or comorbidity between the quintile groups. Participants who started PPAM aid use within 10 days were found to have a shorter time to casting (Mdn=26 days vs 91 days, H(4)=133.387, P