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Background: Patient satisfaction is an important measurement in healthcare for administrators, clinicians and patients. Objectives: This study investigated the role of gait deviation in patient satisfaction following lower-limb amputation and prosthesis prescription. Study design: A cross-sectional study was done. Methods: Twenty community-based unilateral lower-limb amputees, 12 transtibial and 8 transfemoral, were recruited from support groups. Participants completed the prosthesis evaluation questionnaire (PEQ) with embedded satisfactionrelated questions, the timed-up-and-go test and the six-minute walk test, and also underwent quantitative three-dimensional analysis. Kinematic deviation was summarized using the gait profile score (GPS). Results: Satisfaction levels were generally high (median 80 + /100). Sociodemographic variables did not correlate significantly with any of the satisfaction measures (À0.35 r 0.54). Satisfaction correlated strongly with the PEQ scales, particularly ambulation, prosthetic utility, frustration, perceived response and social burden (r ! 0.70). By contrast, the relationships between satisfaction and performance-based outcome measures were not significant (À0.45 r 0.43), and the GPS did not correlate with any satisfaction measures (À0.23 r 0.15). Conclusions: In this study of high functioning amputees, gait deviation was unimportant to the amputee, while selfreported functional ability and attitudes toward the prosthesis were the strongest correlates of satisfaction following lower-limb amputation. Clinical relevanceFor the high functioning individuals with lower-limb amputation in this study, gait deviation was not a significant correlate of patient satisfaction. Results suggest that improving self-perceived functional ability and attitudes toward the prosthesis, rather than minimizing gait deviation, will improve patient satisfaction.

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We used body-worn inertial sensors to quantify differences in semi-free-living gait between stairs and on normal flat ground in older adults, and investigated the utility of assessing gait on these terrains for predicting the occurrence of multiple falls. Eighty-two community-dwelling older adults wore two inertial sensors, on the lower back and the right ankle, during several bouts of walking on flat surfaces and up and down stairs, in between rests and activities of daily living. Derived from the vertical acceleration at the lower back, step rate was calculated from the signal's fundamental frequency. Step rate variability was the width of this fundamental frequency peak from the signal's power spectral density. Movement vigor was calculated at both body locations from the signal variance. Partial Spearman correlations between gait parameters and physiological fall risk factors (components from the Physiological Profile Assessment) were calculated while controlling for age and gender. Overall, anteroposterior vigor at the lower back in stair descent was lower in subjects with longer reaction times. Older adults walked more slowly on stairs, but they were not significantly slower on flat surfaces. Using logistic regression, faster step rate in stair descent was associated with multiple prospective falls over 12 months. No significant associations were shown from gait parameters derived during walking upstairs or on flat surfaces. These results suggest that stair descent gait may provide more insight into fall risk than regular walking and stair ascent, and that further sensor-based investigation into unsupervised gait on different terrains would be valuable.