O impacto da reabilitação protética na capacidade e desempenho funcional de idosos com amputação de membros inferiores: uma revisão narrativa

Abstract

Population aging is accompanied by a considerable increase in the number of elderly patients undergoing amputations. Amputations of lower limbs have a major impact on the functional capacity, autonomy and quality of life of this population. The use of lower limb prostheses can play an important role in restoring and/or improving physical capacity, body image and the ability to perform activities of daily living (ADL) independently. However, many elderlies with lower limb amputations who receive a prosthesis for walking do not reach a high functional level after prosthetic rehabilitation. Therefore, the aim of this study was to perform a literature review on the impact of prosthetic rehabilitation on the functional capacity of elderly people with lower limb amputation for proper direction of the clinical approach to the care of these patients. After searching the Medline databases (via PubMed), SciELO, LILACS and PEDro and manually searching the references, 219 articles were found. Through the analysis of the literature and the inclusion and exclusion criteria, six studies were selected for this review. The total sample consisted of 380 patients, all over the age of 60 who received a prosthesis after rehabilitation. There were patients with different levels and etiologies of amputation, three studies included bilateral amputees. Currently, there are few studies with good methodological quality, which compare the effect of intervention with prosthesis on functional capacity. Despite this, the use of prostheses in elderly with a lower limb amputation was associated with the ability to walk independently or semi-dependently in all articles of this search. The use of prosthesis was also associated with the ability to perform basic and advanced daily tasks most of the time. In some cases, the elderly had a higher rate of return to the situation of independent living at home. In contrast, elderly people who were rehabilitated with a wheelchair or without a prosthesis had a higher rate of institutionalization after amputation. It was concluded that most of the elderly who were rehabilitated with a prosthesis after amputation of the lower limb are able to walk in and around the house with walking aid. Elderly with a lower limb amputation show improvement in functional capacity after prosthetic rehabilitation, but maintain some functional deficit compared to the preamputation period. The methodological quality of the studies and the diversity of measures of the results make it difficult to significantly compare the data. The strength of the conclusions of this review was therefore limited.