PREDICTIVE FACTORS FOR SUCCESSFUL PROSTHETIC REHABILITATION AFTER VASCULAR TRANSTIBIAL AMPUTATION/PREDIKTIVNI CIMBENICI ZA USPJESNU PROTETSKU REHABILITACIJU NAKON VASKULARNE TRANSTIBIJALNE AMPUTACIJE

Lower extremity amputation is a very common amputation and successful prosthetic rehabilitation is a desirable outcome. The aim of this study was to determine which factors affect the success of prosthetic rehabilitation after transtibial vascular amputation. The study included 61 patients who had undergone transtibial amputation (mean age, 64.2[+ or -]10.4 years; 50 (82%) males). Patients who were able to walk at least 45 meters without aids or with only one walking stick after rehabilitation program were classified into the group of successful prosthetic users. Age, gender, comorbidities, patency of the popliteal artery, wound healing complications, and presence of the phantom limb pain were used as predictive variables. Multivariate logistic regression analysis was used to identify predictive factors of successful prosthetic rehabilitation. The model included all variables explaining up to 59.8% of variance, however, only age, absence of functional patency of the popliteal artery and compromised wound healing made significant contribution to the model. In conclusion, good general condition of the patient and sustained patency of the popliteal artery reliably led to clinical improvement and realization of full capacity of rehabilitation after below-knee amputation. Key words: Amputation, transtibial; Lower limb; Rehabilitation, prosthetic Amputacija donjih ekstremiteta vrlo je cesta amputacija, a uspjesna protetska rehabilitacija je pozeljan ishod. Cilj ovog istrazivanja bio je utvrditi koji cimbenici utjecu na uspjeh protetske rehabilitacije nakon transtibijalne vaskularne amputacije. U studiju je ukljucen 61 bolesnik podvrgnut transtibijalnoj amputaciji (srednja dob 64,2[+ or -]10,4 godine; 50 (82%) muskaraca). Bolesnici koji su nakon programa rehabilitacije mogli prijeci najmanje 45 metara bez pomagala ili sa samo jednim stapom za hodanje svrstani su u skupinu s uspjesnom protetskom rehabilitacijom. Kao prediktivne varijable primijenili smo dob, spol, subolesti, prohodnost poplitealne arterije, komplikacije zacjeljivanja rana i prisutnost fantomske boli udova. Multivarijatna logisticka regresijska analiza koristena je za utvrdivanje prediktivnih cimbenika uspjesne protetske rehabilitacije. Model je obuhvacao sve varijable koje su objasnjavale do 59,8% varijance, medutim, samo su dob, nepostojanje funkcionalne prohodnosti poplitealne arterije i ugrozeno zacjeljivanje rana dali znacajan doprinos modelu. U zakljucku, dobro opce stanje bolesnika i trajna