Balance confidence and activity of community-dwelling patients with transtibial amputation

Abstract

Abstract-The purpose of this study was to examine the relationship between balance confidence and community-based physical activity. Twenty-two community-dwelling patients with right or left unilateral transtibial amputation who reported no falls in the past 6 mo completed the Activities-Specific Balance Confidence Scale (ABC) and wore a StepWatch Activity Monitor for 7 consecutive d in the community. Subjects were subsequently stratified as low (<3,000 steps/d) or high (3,000 steps/ d) activity groups. Balance confidence was significantly lower among the low activity weekday group (LAG) (70.8 +/-12.0 vs 88.9 +/-8.7, t(20) = 3.97, p = 0.001). Further, correlation analysis revealed a positive correlation between ABC score and step total (r = 0.55, p < 0.01). It is unknown whether the LAG limited ambulation as an intentional strategy of fall-risk avoidance. Although clinicians routinely inquire about falls in the community among patients with lower-limb amputation, the results of this study emphasize the importance of contextualizing recent fall history relative to activity level. Clinicians can use this contextual information when considering the inclusion of appropriate fall-risk mediation strategies relative to activity levels and counseling patients on the benefits of physical exercise for maintaining functional capacity and general health.

Using Clinical Balance Tests to Assess Fall Risk among Established Unilateral Lower Limb Prosthesis Users: Cutoff Scores and Associated Validity Indices

“…The study sample also consisted of a larger percentage of traumatic LLP users (i.e., 62.5%) than is reported in the literature (i.e., 17%-60.2%) 24,[54][55][56][57][58] , potentially limiting the generalization of study results. While this is a challenge in most 15,23,25,66,67 , but not all 8,21,[68][69][70] research involving LLP users, future efforts to include a larger proportion of dysvascular LLP users is required to increase generalization of study results. The mean age of our sample, 48.7, was slightly younger than that reported in larger, national studies of individuals with lower limb amputation (i.e., mean age from 50 to 55) [54][55][56]58 , yet the range of ages studied, 24 to 70, is consistent with those prior studies.…”