031) but did not possess the predictive magnitude of the other clinical prediction rules. To improve www.selleckchem.com/products/AZD6244.html the clinical utility of the 12-month clinical prediction rules, future research may incorporate a follow-up assessment at 6-months post-discharge. Amputation rate has been reported as being 38 times greater in Aboriginals who have diabetes.41 In the present study,

indigenous status, geographical isolation from health services and having diabetes were not predictive of prosthetic non-use. Environmental conditions in Aboriginal communities, where the terrain is rough, sociocultural factors and service model strategies such as telehealth may have contributed to sustained prosthetic use. The present research had some potential limitations. The prosthetic-use interview relied on participant recall. Missing data is a potential issue for retrospective research; however, a strength of the present study was that it had minimal missing data. Mortality rate was high within the review period for the retrospective (16%) and prospective (10%) cohorts; however, the sensitivity analyses demonstrated that the deceased sub-groups did not bias click here clinical prediction rules development or validation. Although further validation could be undertaken at other rehabilitation

centres, the use of the prospective cohort in the present study validates the use of these clinical prediction rules by health professionals. In conclusion, this is the first study to integrate rehabilitation variables into a parsimonious set of predictors that are significant for prosthetic non-use at 4, 8 and 12 months after discharge, and validate these clinical prediction rules. The research

has validated that a sub-group of early prosthetic non-users exists, and highlights a need to separate causative factors for amputation that impact on surgical outcome, from those related to prosthetic non-use. These validated clinical prediction rules may guide clinical reasoning and rehabilitation service development. What is already known on this topic: Long-term functional use of a prosthesis following discharge from hospital is important for quality of life for lower limb amputees. What this study adds: Clinical prediction rules can provide valid data to help identify people who are at risk of discontinuing ADP ribosylation factor use of their prosthesis in the year following discharge from hospital after lower limb amputation. Different predictors contribute to these clinical prediction rules, depending on the time frame considered (4, 8 or 12 months). Amputation above the transtibial level and use of a mobility aid were predictors that were common to the clinical prediction rules for all three time frames. eAddenda: Figures 3, 4 and 5, Tables 1 and 4, and Appendices 1 and 2 can be found online at doi:10.1016/j.jphys.2014.09.003 Ethics approval: This research was approved by the Royal Perth Hospital and Curtin University Ethics Committees. Source(s) of support: ISPO Australia Research Grant.