INTERIM PROSTHESIS PILOT TRIAL AN UPDATE FEB 2008

AIMS OF TRIALPilot trial to integrate acute prosthetic service delivery using private and public prosthetic services.Compare the cost and outcomes of private and public prosthetic services of fabricating mechanical interim prosthesis.Determine relevant and practical outcome measures for amputee rehabilitation services.

BACKGROUND OF TRIALTwo SitesJHH/RPCEmploy additional onsite public prosthetist to make mechanical interims.WESTMEADContract services from private company (APC) to make mechanical interims.

Reflects current / possible service provision

BACKGROUND OF TRIALTrial began in February 2006 at Westmead hospital and May 2006 at John Hunter/Rankin Park. Public prosthetist used existing onsite facilities located next to the rehabilitation gym at Rankin Park.Private Prosthetic on call service at Westmead hospital. Prosthetist attend rehabilitation gym to see patients.

OUTCOME MEASURESBasic demographic dataAgeGenderCo-morbiditiesInsurance statusMilestone dates Functional Scales and measures (see over)Variance

FUNCTIONAL OUTCOME MEASURES

COMPARISON OF DATANumbersDemographicsMilestone DatesFunctional Outcome Measures

PATIENT NUMBERS

DEMOGRAPHICSSimilar in age, sex and side of amputation.Differences in level of amputation. Higher rate (38.6%) TFA at JHH compared with Westmead (20.8%)Higher percentage of cause being PVD or DM at Westmead (83%) compared to JHH (62%)

DEMOGRAPHICS

Chart3

3139

2211

43

4241

1512

2523

3230

2426

1218

65

51

112

3431

2322

John Hunter

Westmead

Demographic

COMPARISON OF DEMOGRAPHICS

Sheet1

Unilateral BK's2006/2007

NO.PatientAmp DateCause ofSideRehab AdmissionRehab AdmissionRehab D/CDischargeHospital LOSRehab LOSInterim legAMP to InterimStartDefinativeInterim toDischarge fromAgeAMP No ProK- ClassAmpProK ClassTGUAG10m walk2min WalkLCISATPRO

AmputationFIMFIMhomeafter AmputationPhysiolegDefinitivephysio

1Tleige, Khatib1/9/06DM/PVDLeft2/8/0630TFA otherside

2Dove, Peter2/3/06PVDLeft3/3/06283/1/06267/11/0613262Moved back to rural area data incomplete

3Whiteley, Ray3/11/06DMRight4/5/06253/31/062048RIP

4Cahill, Jeanine3/3/06DMLeft4/13/06414/5/06337/13/0699372523738.637.9311239.0018.0057.00

5Bernardinis, John2/8/06DMLeft3/20/06404/12/06634/3/0612/8/0624010/27/06513630.00

6Fayle, Bill2/8/06PVDLeft3/2/063/30/06505/24/061054/11/0711/29/061892/12/077530240315.2813.256345.0025.0050.00

7Shawkey, Mohamed6/16/06DMLeft6/26/061021168/15/0660507/31/064511/30/06122702223529.308.208650.0022.0053.00

8Davies, RogerTraumaLeft08/18/0637383

9Flahey, Paul8/16/06PVDRight8/25/061141209/12/0627189/27/064210/4/063/1/071557/18/077014.2312.656542.0033.0042.00

10Porter, Eric10/22/07PVDRight11/21/073011/17/072611/23/0662Moved back to rural area definitive limb made elsewear

11Hales, Margaret10/1/06PVDRight10/24/061001181/28/071199611/23/06531/31/075/11/071697127236321.0020.854045.0026.0049.00

12Clarke, Ruth10/20/06DMRight11/30/0674811/27/07995812/5/06465/17/071637813124125.3018.0030

13Hanna, Sam8/29/06PVDRight9/6/06812/15/0644Ulcer on leg nil definitive yet

14Iskander, SamDMLeft2/7/0661191

15McGrath, Daniel12/12/06DMRight1/10/07292/12/07621/29/076/21/0712941222

16Palangas, Steve1/5/07PVDLeft1/19/07911133/30/0784702/15/07416/7/071128620241313.5312.227052.0025.0050.00

17Hanna, Mark2/2/07PVDRight2/20/071201212/28/072683/14/07403/5/078/16/071553337356.0026.0049.00

18Smith, Eric2/15/07PVDLeft3/6/07803/21/0734153/14/07276/20/0798653634337.577.2511052.0022.0053.00

19Baldwin, Bill12/1/06DMRight12/15/06143/27/0711612/18/065/23/07574818130240.8031.706020.0023.0052.00

20Haszcnyzyk, Michael2/27/07PVDLeft3/13/073/22/072394/4/07364/4/07503634038.347.1011252.0019.0056.00

21John Downey3/15/07DMRight4/3/071121186/1/0778594/23/07396/4/079/20/071507419135213.8010.808749.0016.0059.00

22Michael Mantoufeh5/23/07DM/PVDLeft5/23/07701097/20/0758586/15/07237/24/0710/11/071187219131220.2015.605633.0033.0042.00

23Mark Moulds4/17/07DMLeft7/21/07956/14/07588/27/0712/13/071824922225128.0016.404532.0017.0058.00

24Michael Lanyon5/16/07DMRight5/29/071071227/13/0758456/18/07337/18/07402224338.977.5712553.0022.0053.00

25Ilma Saunders5/25/07PVDRight6/19/0783957/19/0755306/27/07337/27/0773141

26Thomas Palmer6/12/07DMRight6/28/0779917/20/0738227/9/07277/25/0710/31/07114711814039.408.7013051.0015.0060.00

27Pat Smith1/30/07PVDLeft4/19/0760765/16/07106277/26/071775/23/0766101

28Anthony Hutchinson10/4/06PVDLeft10/24/06798711/29/0656367/9/0712/6/0658343

29William Millar3/2/07PVDRight5/11/07704/2/07315/15/077/3/0710/18/077020238311.809.809531.0022.0053.00

30Boot, Maria7/10/07PVDRight9/12/07648/30/075111/15/071/15/087213118170.1076.1013.00=

31Tia Tia, Peter5/23/07DMRight7/13/0765658/31/07100498/30/07991/14/081376021232219.1012.9062.0030.0016.00

32Farquarson8/23/07DMLeft10/26/076412/3/0769732223739.888.34117

33Smith, Jeff9/26/07TraumaLeft10/29/073310/28/0732423734348.435.38160.00

34Spiteri9/25/07PVDRight10/15/079612312/13/07795910/30/07357033216.808.65100.0054.0015.0060.00

35Darnely, Kathleen8/31/07PVDRight10/18/077511311/15/07762810/26/075656

36Bowen, Lesley10/11/07DMLeft10/13/07211/20/074074

37McCormack, FionaTraumaLeft

38Whittiker, RichardPVDRight

39Balangue, MichealTraumaLeft

89104524150.44140Mean61.2023.291.8834.672.3918.7715.7082.2643.8822.0052.6087.67

40Standard Deviation14.018.510.807.090.8515.0415.9038.2011.075.705.67

Median65.0021.502.0035.502.5013.8010.8086.0049.5022.0053.00

Range37-8610-371-335-432-37.57-70.17.25-76.113-13020-5615-33

homeInterim legDefinativedaysto definative

AV = (59)AV=(85.43)Av=(151)Av=(160)Av=(79.68)

Median = (33.5)Median=(57)Median=(132)Median=(147)Median=(57.5)

Amp DateDischargeInterim legStartDefinativeDischarge from

homePhysiolegphysio

1George Congerton10/6/06PVDLeft11/1/069311212/22/067711/17/06421/9/077718125173681862451.00

2Wayne Fensom7/10/06TraumaLeft7/14/0649/9/06618/19/064239342310.728.683532154.00

3Jozo Jedinak3/20/06PVDLeft4/11/06901045/4/06454/28/06395/11/067518122112132451.00

4Aleksy Paszyn6/2/06PVDLeft7/27/068911310/22/0614210/4/0612411/6/067827230238.231.432292253.00

5Max Richards4/10/06PVDLeft4/19/06921195/24/06447/10/06916/14/067/10/067125239312.611.564422253.00

6Alex Sarkany2/12/07PVDLeft1/23/0771982/10/072/15/072/13/077230231253.56515222253.00

7Bernie Walsh8/24/06PVDRight9/22/069410010/17/06549/29/063610/23/07393834439.36.1112561857.00

8Noel Wasson5/4/07PVDLeft5/16/0780956/20/07476/4/07316/26/0774222

9Robert Boulter3/27/07TumorLeft4/11/071071144/27/07314/25/07295/1/077528242.130.630293441.00

10Graham WhitehallotherRight

11Saula ArkarvellaPVDLeft

12Kubelka, EddieLeft5657Mean67.0027.222.0033.292.1434.2031.6045.7531.2523.3851.6386.04

Standard Deviation15.207.630.718.520.9024.4825.9036.6518.004.69

Median74.0027.002.0031.002.0038.2030.6031.0029.0022.00

Range39-7818-391-322-441-39.3-53.56.1-6.512-1126-5618-24

Male41

Female10

TFA11John HunterWestmead

TTA39TTA3139

Bilateral TTA3TFA2211

OTHER43

MALE4241

FEMALE1512

653230

PVD2426

DM1218

TRAUMA65

22 rightTUMOR51

30 leftOTHER112

LEFT3431

RIGHT2322

Sheet1

LCI

Sheet2

John Hunter

Westmead

Demographic

COMPARISON OF DEMOGRAPHICS

Sheet3

299

132

390.00

99

240

164

189

109

122

132

264

215

155

173

124

194

180

49

163

36

129

128

112

155

98

162.04

8Mar20062Apr2007Jan200631

Feb200628

Mar200631

Apr200630

May200631

Jun200630

Jul200631

Aug200631

Sep200630

Oct200631

Nov200631

Dec200631

Jan200731

Feb200728

Mar200731

Apr200730

May200731

Jun200730

Jul200731

Aug200731

Sep200731

Oct200731

Nov200730

Dec200731

RRD PROGRAMMEBoth sites have found that the application of RD or RRD postoperatively does impact on stump volume and interim fittingAt Westmead it was found that those who were not fitted with a RD immediately postoperatively started at a higher stump volume and took longer to stabilise in size than those who were.

RRD PROGRAMME

Chart1

39.638663105436.478260869633.317858633743.172887521540.071428571436.9699696213

37.414698118434.665217391331.915736664242.449853154338.666666666734.8834801791

36.380714275833.523809523830.666904771842.871692944137.944444444433.0171959447

35.437347836333.157894736830.878441637440.507895849435.666666666730.8254374839

33.460226445731.291666666729.123106887737.780516041433.857142857129.9337696729

33.67698556631.230769230828.784552895539.190415759834.529.8095842402

32.616025546230.4528.283974453838.895386282933.7528.6046137171

33.623234146530.545454545527.467674944437.340751572532.7528.1592484275

RD Mean + SD

RD Mean

RD Mean - SD

Soft Dressing Mean + SD

Soft Dressing Mean

Soft Dressing Mean - SD

Weeks Post Operatively

Stump Measurements End of Tibia (cm)

Comparison of Stump Measurements Post Operatively 2006/2007Rigid Dressing vs Soft Dressing

Sheet1

PatientAmputation DateRD/RRDWeek 1Week 2Week 3Week 4Week 5Week 6Week 7Week 8Week 9Week 10

CarruthersYes37353132302928

Zvirgzdins3/10/06Yes36.5323431.5

Dove2/3/06Yes363633.531.530.530313131

Saunders5/25/07Yes363432.533323433

AlwanYes36.533.333.533.53028.52926.5

Cahill3/3/06Yes40.5383635.53332.5

whitely3/11/06Yes323228

Tleige1/9/06Yes35.5333332.52626262627

LopezYes37333633.53127.527.5

CraigYes37.53534

Downey3/15/07Yes383634323231313331.532.5

WhittikerYes38.5363535.533.533.532.532.532.5

FarquharsonYes3232333032

GrimaYes29.52927

Millar3/2/07Yes3332303031292828

DaviesYes33.5343432313031

Clarke10/20/06Yes4142413534.5

Moulds5/17/07Yes373434333230.5

Haszczywnyk2/27/07Yes363534

SkaliarisYes4339.535.53332.5

SkaliarisYes38383534.534353434.5

FlackYes403735.535

Spiteri9/25/07Yes343232313131.530.531.00

Roop11/12/07Yes3737

Carroll11/16/07Yes33

36.4834.6733.5233.1631.2931.2330.45

PatientAmputation DateRD/RRDWeek 1Week 2Week 3Week 4Week 5Week 6Week 7Week 8Week 9Week 10

Hanna, Mark2/2/07No434240

RosikNo40.538.538

Palmer6/12/07No4342403839.539.536.5

Lanyon5/16/07No43.5424240.538394039

Baldwin12/1/06No44383436

Mantoufeh5/23/07No4037.537.5343333.532.53333

Tia TiaNo39.538373532.5333231.5

Palangas1/5/07No4041383735353230.53230.5

Smith, E2/15/07No343630

AzzopardiNo34322726.526.525.526.526

40.0738.6737.9435.6733.8634.5033.7532.75

Mean36.4834.6733.5233.1631.2931.2330.4530.55

StDev3.162.752.862.282.172.452.173.08

Mean40.0738.6737.9435.6733.8634.5033.7532.75

StDev3.103.784.934.843.924.695.154.59

12345678

RD SD high39.6437.4136.3835.4433.4633.6832.6233.62

RD Mean36.4834.6733.5233.1631.2931.2330.4530.55

RD SD low33.3231.9230.6730.8829.1228.7828.2827.47

Crepe SD high43.1742.4542.8740.5137.7839.1938.9037.34

Crepe Mean40.0738.6737.9435.6733.8634.5033.7532.75

Crepe SD high36.9734.8833.0230.8329.9329.8128.6028.16

Sheet1

0000000000000000000000

0000000000000000000000

0000000000000000000000

0000000000000000000000

0000000000000000000000

0000000000000000000000

0000000000000000000000

0000000000000000000000

0000000000000000000000

0000000000000000000000

Weeks Post Op

Stump Circumference (cm)

Post Operative Stump Measurements with RRD

Sheet2

Weeks

Stump Circumference (cm)

Post Operative Stump Measurements without RRD

Sheet3

RD Mean + SD

RD Mean

RD Mean - SD

Soft Dressing Mean + SD

Soft Dressing Mean

Soft Dressing Mean - SD

Weeks Post Operatively

Stump Measurements End of Tibia (cm)

Comparison of Stump Measurements Post Operatively 2006/2007Rigid Dressing vs Soft Dressing

RRD PROGRAMMEAt JHH those patients who had an RRD applied within 7 days were fitted with an interim prosthesis on average 9 days sooner than those who were not.Furthermore, there stump had matured to be ready for a definitive on average 3 months sooner than those who had soft dressings.

MILESTONE DATES

Chart4

52.250.44

44.652

John Hunter

Westmead

Level of Amputation

Days

Time from Amputation to Interim Fitting

Sheet1

Unilateral BK's2006/2007

NO.PatientAmp DateCause ofSideRehab AdmissionRehab AdmissionRehab D/CDischargeHospital LOSRehab LOSInterim legAMP to InterimStartDefinativeInterim toDischarge fromAgeAMP No ProK- ClassAmpProK ClassTGUAG10m walk2min WalkLCISATPRO

AmputationFIMFIMhomeafter AmputationPhysiolegDefinitivephysio

1Tleige, Khatib1/9/06DM/PVDLeft2/8/0630TFA otherside

2Dove, Peter2/3/06PVDLeft3/3/06283/1/06267/11/0613262Moved back to rural area data incomplete

3Whiteley, Ray3/11/06DMRight4/5/06253/31/062048RIP

4Cahill, Jeanine3/3/06DMLeft4/13/06414/5/06337/13/0699372523738.637.9311239.0018.0057.00

5Bernardinis, John2/8/06DMLeft3/20/06404/12/06634/3/0612/8/0624010/27/06513630.00

6Fayle, Bill2/8/06PVDLeft3/2/063/30/06505/24/061054/11/0711/29/061892/12/077530240315.2813.256345.0025.0050.00

7Shawkey, Mohamed6/16/06DMLeft6/26/061021168/15/0660507/31/064511/30/06122702223529.308.208650.0022.0053.00

8Davies, RogerTraumaLeft08/18/0637383

9Flahey, Paul8/16/06PVDRight8/25/061141209/12/0627189/27/064210/4/063/1/071557/18/077014.2312.656542.0033.0042.00

10Porter, Eric10/22/07PVDRight11/21/073011/17/072611/23/0662Moved back to rural area definitive limb made elsewear

11Hales, Margaret10/1/06PVDRight10/24/061001181/28/071199611/23/06531/31/075/11/071697127236321.0020.854045.0026.0049.00

12Clarke, Ruth10/20/06DMRight11/30/0674811/27/07995812/5/06465/17/071637813124125.3018.0030

13Hanna, Sam8/29/06PVDRight9/6/06812/15/0644Ulcer on leg nil definitive yet

14Iskander, SamDMLeft2/7/0661191

15McGrath, Daniel12/12/06DMRight1/10/07292/12/07621/29/076/21/0712941222

16Palangas, Steve1/5/07PVDLeft1/19/07911133/30/0784702/15/07416/7/071128620241313.5312.227052.0025.0050.00

17Hanna, Mark2/2/07PVDRight2/20/071201212/28/072683/14/07403/5/078/16/071553337356.0026.0049.00

18Smith, Eric2/15/07PVDLeft3/6/07803/21/0734153/14/07276/20/0798653634337.577.2511052.0022.0053.00

19Baldwin, Bill12/1/06DMRight12/15/06143/27/0711612/18/065/23/07574818130240.8031.706020.0023.0052.00

20Haszcnyzyk, Michael2/27/07PVDLeft3/13/073/22/072394/4/07364/4/07503634038.347.1011252.0019.0056.00

21John Downey3/15/07DMRight4/3/071121186/1/0778594/23/07396/4/079/20/071507419135213.8010.808749.0016.0059.00

22Michael Mantoufeh5/23/07DM/PVDLeft5/23/07701097/20/0758586/15/07237/24/0710/11/071187219131220.2015.605633.0033.0042.00

23Mark Moulds4/17/07DMLeft7/21/07956/14/07588/27/0712/13/071824922225128.0016.404532.0017.0058.00

24Michael Lanyon5/16/07DMRight5/29/071071227/13/0758456/18/07337/18/07402224338.977.5712553.0022.0053.00

25Ilma Saunders5/25/07PVDRight6/19/0783957/19/0755306/27/07337/27/0773141

26Thomas Palmer6/12/07DMRight6/28/0779917/20/0738227/9/07277/25/0710/31/07114711814039.408.7013051.0015.0060.00

27Pat Smith1/30/07PVDLeft4/19/0760765/16/07106277/26/071775/23/0766101

28Anthony Hutchinson10/4/06PVDLeft10/24/06798711/29/0656367/9/0712/6/0658343

29William Millar3/2/07PVDRight5/11/07704/2/07315/15/077/3/0710/18/077020238311.809.809531.0022.0053.00

30Boot, Maria7/10/07PVDRight9/12/07648/30/075111/15/071/15/087213118170.1076.1013.00=

31Tia Tia, Peter5/23/07DMRight7/13/0765658/31/07100498/30/07991/14/081376021232219.1012.9062.0030.0016.00

32Farquarson8/23/07DMLeft10/26/076412/3/0769732223739.888.34117

33Smith, Jeff9/26/07TraumaLeft10/29/073310/28/0732423734348.435.38160.00

34Spiteri9/25/07PVDRight10/15/079612312/13/07795910/30/07357033216.808.65100.0054.0015.0060.00

35Darnely, Kathleen8/31/07PVDRight10/18/077511311/15/07762810/26/075656

36Bowen, Lesley10/11/07DMLeft10/13/07211/20/074074

37McCormack, FionaTraumaLeft

38Whittiker, RichardPVDRight

39Balangue, MichealTraumaLeft

89104524150.44140Mean61.2023.291.8834.672.3918.7715.7082.2643.8822.0052.6087.67

40Standard Deviation14.018.510.807.090.8515.0415.9038.2011.075.705.67

Median65.0021.502.0035.502.5013.8010.8086.0049.5022.0053.00

Range37-8610-371-335-432-37.57-70.17.25-76.113-13020-5615-33

homeInterim legDefinativedaysto definative

AV = (59)AV=(85.43)Av=(151)Av=(160)Av=(79.68)

Median = (33.5)Median=(57)Median=(132)Median=(147)Median=(57.5)

Amp DateDischargeInterim legStartDefinativeDischarge from

homePhysiolegphysio

1George Congerton10/6/06PVDLeft11/1/069311212/22/067711/17/06421/9/077718125173681862451.00

2Wayne Fensom7/10/06TraumaLeft7/14/0649/9/06618/19/064239342310.728.683532154.00

3Jozo Jedinak3/20/06PVDLeft4/11/06901045/4/06454/28/06395/11/067518122112132451.00

4Aleksy Paszyn6/2/06PVDLeft7/27/068911310/22/0614210/4/0612411/6/067827230238.231.432292253.00

5Max Richards4/10/06PVDLeft4/19/06921195/24/06447/10/06916/14/067/10/067125239312.611.564422253.00

6Alex Sarkany1/12/07PVDLeft1/12/0771982/10/07292/15/07342/13/077230231253.56515222253.00

7Bernie Walsh8/24/06PVDRight9/22/069410010/17/06549/29/063610/23/07393834439.36.1112561857.00

8Noel Wasson5/4/07PVDLeft5/16/0780956/20/07476/4/07316/26/0774222

9Robert Boulter3/27/07TumorLeft4/11/071071144/27/07314/25/07295/1/077528242.130.630293441.00

10Graham WhitehallotherRight

11Saula ArkarvellaPVDLeft

12Kubelka, Eddie2/3/06PVDLeft2/27/063/8/0633Mean67.0027.222.0033.292.1434.2031.6045.7531.2523.3851.6386.04

5352.00Standard Deviation15.207.630.718.520.9024.4825.9036.6518.004.69

Median74.0027.002.0031.002.0038.2030.6031.0029.0022.00

Range39-7818-391-322-441-39.3-53.56.1-6.512-1126-5618-24

Male41

Female10

TFA11John HunterWestmeadJohn HunterWestmead

TTA39TTA52.250.44TTA3139

Bilateral TTA3TFA44.652TFA2211

OTHER43

MALE4241

FEMALE1512

653230

PVD2426

DM1218

TRAUMA65

22 rightTUMOR51

30 leftOTHER112

LEFT3431

RIGHT2322

Sheet1

39

45

50

42

45

30

52

56

52

20

52

49

33

32

53

51

31

13

30

LCI

Sheet2

John Hunter

Westmead

Demographic

COMPARISON OF DEMOGRAPHICS

Sheet3

John Hunter

Westmead

Level of Amputation

Days

Time from Amputation to Interim Fitting

299

132

390.00

99

240

164

189

109

122

132

264

215

155

173

124

194

180

49

163

36

129

128

112

155

98

162.04

8Mar20062Apr2007Jan200631

Feb200628

Mar200631

Apr200630

May200631

Jun200630

Jul200631

Aug200631

Sep200630

Oct200631

Nov200631

Dec200631

Jan200731

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EARLY PROSTHETIC FITTINGAt both Westmead and JHH it has been evident that fitting of mechanical interim prosthesis made by a prosthetist has allowed earlier fitting for some patientsAt Westmead 2004/2005 mean time from amputation to fitting of plaster temporary = 86 days compared to 51 days for interim legs in 2006/2007. 37 days difference. At JHH some patients with significant wounds were fitted with a interim prosthesis.

EARLY PROSTHETIC FITTING

MILESTONE DATES

MILESTONE DATES

Slightly shorter rehabilitation LOS at Westmead hospital. Large difference between sites regarding admission and discharge motor FIM scores.Large difference between FIM scores due to patient population or ? different calculation of motor component of FIM between sites.Improved % change in motor FIM score for JHH compared to 2 years prior to interim programme.

MEAN FUNCTIONAL OUTCOME MEASURES AT DEFINITIVE

COMPARISON OF FUNCTIONAL OUTCOME MEASURESSignificant difference between mean TGUAG, 10m walk and 2min walk between sites. Nil difference on the LCI between sites, despite differences in above measures.SATPRO slightly higher at Westmead.? reason for the difference in outcome between sites:Patient populationRehabilitation process Requires more detailed statistical analysis.

EXPERIENCE WITH OUTCOME MEASURES

Numerous outcome measures were used in this pilot trial

The therapists felt that some were easier to administer and gave more relevant and useful information than others.

EXPERIENCE WITH OUTCOME MEASURES: AMPnoPRO/AMPPROThe AMPnoPro and AMPPRO were relatively easy to administer, however its predictive capacity was questioned by both sitesAt JHH it was found that 39% of the time the predicted K classification by the AMPnoPRO did not match the clinicians prediction.The AMPPRO did not match the observed K classification 29% of the time. At Westmead an identical result was found with 39% of the time, the AMPnoPro failed to predict the final K classificationDiscrepancy may be due to the fact the co-morbidity score should have been factored in, however it was not clear how this should be done.

RECOMMENDATIONS FOR USE OF OUTCOME MEASURESThe LCI, SATPRO and TGUAG were quick and easy for the therapist to administer and gave a fair indication of the patients functional ability.It is therefore recommended that these should be used as standard measurements at clinics to assess change of function when prescribing new prostheses. The 2min or 6min walk takes longer to administer but is a useful indicator of endurance and ability to community ambulate.

SUMMARYFurther analysis of data to determine causes/reasons for differences in outcome measures between the two sitesUse the extensive data collected to develop more specific research projects in the future.Recommendations regarding implementation at other sites.

QUESTIONS/COMMENTS