Fred A. de Laat, Pieter U. Dijkstra, Gerardus M. Rommers, Jan H.B. Geertzen, Leo D. Roorda
Rehabilitation Centre Leijpark, Libra R&A, NL-5004 KE Tilburg, The Netherlands. E-mail: f.delaat@libranet.nl
DOI: 10.2340/16501977-2336

Objective: To describe the prevalence of comorbidity and its relationship with demographic and clinical characteristics in persons wearing a prosthesis after lower-limb amputation.
Design: Cross-sectional study.
Subjects/patients: Persons wearing a prosthesis after lower-limb amputation (n = 171; mean age 65 years (standard deviation 12); 72% men) at the end of outpatient rehabilitation treatment.
Methods: Comorbidity was assessed with the Func-tional Comorbidity Index: a list of 18 items addressing the presence of specific comorbid conditions impacting on functional status. Comorbidities in medical records were assessed independently by 2 assessors. Associations with demographic and clinical characteristics were analysed using linear or logistic regression.
Results: The median (interquartile range) number of comorbidities was 3 (2; 4). Three or more comorbidities were present in 103 of 171 (60%) participants. Diabetes was present in 71 (41%), cardiac disease in 60 (35%), and lumbago/degenerative disc disease in 39 (23%) participants. The prevalence of comorbidities was higher in women and those with vascular cause of amputation.
Conclusion: There is a high prevalence of comorbidity at the end of outpatient rehabilitation treatment in persons wearing a prosthesis after a lower-limb amputation, especially in women and those with vascular cause of amputation.

Persons who have undergone an amputation of a leg, frequently suffer from other diseases. Because these other diseases can influence prosthetic training, especially exercise therapy, we explored which diseases at which frequencies are prevalent at the start of the prosthetic training. We found that the prevalence of diseases was higher in women and those with an amputation caused by vascular disease. The most prevalent diseases were, besides vascular disease, diabetes, lumbago, and arthritis. Especially women had a higher prevalence of arthritis and anxiety or panic disorders. Therefore we recommend to screen for these diseases actively in women, because it may be necessary to adapt the prosthetic training for these persons.

Table SI