Models of care are associated with time taken to achieve key rehabilitation milestones in patients undergoing lower limb amputation: The 4th European Congress of the European Region of the World Confederation of Physical Therapy (ER-WCPT) Abstracts, Liverpool, UK, 11-12 November 2016

Relevance: Currently there is minimal evidence or con- sensus regarding the optimal model of care for people undergoing lower limb amputation. This research explores the current models of care post-amputation in Scotland and how they relate to achievement of key rehabilitation mile- stones and outcomes. The findings have implications for research, education and practice. Purpose: The aim of the research was to identify the different models of care post-amputation in Scotland and explore how these models of care relate to achievement of rehabilitation milestones and outcomes for persons undergo- ing unilateral transtibial amputation. Methods/analysis: Mixed methods, retrospective cross- sectional analysis of data from a national audit conducted by the Scottish Physiotherapy Amputee Research Group (SPARG). Quantitative analysis explored between-centre differences in time to reach rehabilitation milestones and outcomes. Semi-structured interviews were conducted with the lead physiotherapists in the 13 major amputating sites in Scotland and focus group discussions were completed with patients to identify models of care. Participants for the quantitative analysis were all patients (age >18) undergoing transtibial amputation between 1st January 2011 and 31st December 2012 (n=627). All lead physiotherapists in the 13 major amputating centres were interviewed (n=15) and 30 patients participated in the focus group discussions. The primary outcome measures were days to reach key rehabilitation milestones, Locomo- tor Capabilities Index 5 (LCI5) score and prosthetic fitting outcomes. The audio recordings of the semi-structured interviews and focus groups were transcribed verbatim and the con- tent of the discussions were explored using thematic analysis. The quantitative data were grouped by amputating centre and descriptive analysis and Kruskal–Wallis tests were used to examine for inter-group differences. Results: Seven key aspects of models of care were iden- tified and a scoring system developed. Scoring of the major amputating centres revealed wide variation. Participants in centres with higher scores were found to have fewer days to reach key rehabilitation milestones: days to PPAM aid use (Mdn=11 days vs 34 days, H(9)=64.075, p