Physical disability after severe lower-extremity injury

OBJECTIVE: To investigate the use of a combined measure of decreased walking speed and gait deviation to identify high physical disability in patients with lower-limb salvage. DESIGN: Longitudinal study of patients with severe lower-extremity trauma. SETTING: Eight level I trauma centers. PARTICIPANTS: Patients (N=276) with lower-limb salvage from the Lower Extremity Assessment Project. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Disability from the physical dimension of the Sickness Impact Profile (SIP), walking speed, and gait deviation were measured at 24 months of follow-up. A 1-way analysis of variance and planned comparisons compared mean SIP scores across and between the following 3 outcome groups: no impaired speed and no gait deviation, impaired speed or gait deviation, and impaired speed and gait deviation. RESULTS: Mean SIP scores for the physical dimension and its 2 categories of ambulation and body care and movement differed statistically across the planned comparisons. The mobility category showed that the impaired speed or deviation group was statistically similar to the group without impaired speed and gait deviation. CONCLUSIONS: The combination of decreased walking speed and gait deviation appears to provide a valid measure of physical disability among patients with lower-limb salvage.