Association of self-reported cognitive concerns with mobility in people with lower limb loss

Kelly, Valerie E.; Morgan, Sara; Amtmann, Dagmar; Salem, Rana; Hafner, Brian J.

doi:10.1080/09638288.2016.1243162

Cited by 14 publications

(14 citation statements)

References 54 publications

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“…Many persons with lower limb amputation have reported the need to "concentrate on every step" and this may reflect increased use of cognitive resources [11]. Cognition has an impact on walking performance, and the current literature on lower limb amputation recognises this relationship [12,13,14,15,16]. Hence, it is important that outcome measures reflect the complexity of mobility in daily life by including both cognitive and environmental dimensions, and at the same time are easy and quick to administer in a clinical setting [6].…”

Section: Introductionmentioning

confidence: 99%

Assessing mobility for persons with lower limb amputation: the Figure-of-Eight Walk Test with the inclusion of two novel conditions

Schack

Mirtaheri

Steen

et al. 2019

Disability and Rehabilitation

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Purpose: To investigate the internal consistency, convergent and known-groups construct validity of the Figure-of-Eight Walk Test with two novel conditions in persons with lower limb amputation, and to examine differences in walking performance between the three conditions within a group of persons with transtibial amputation and transfemoral amputation/knee disarticulation. Materials and methods: 50 adults with unilateral amputation participated, 28 of whom had undergone a transtibial amputation and 22 a transfemoral amputation/knee disarticulation. Three Figure-of-Eight Walk Test Conditions were investigated: 1) walking at a self-selected walking speed, 2) walking while carrying a tray with two cups of water and 3) walking on uneven terrain. Internal consistency was evaluated using Cronbach's alpha. Convergent construct validity was examined by analysing the relationship between the Figure-of-Eight Walk Test parameters and performance-based parameters (Amputee Mobility Predictor, Ten-Meter Walk Test, Six-Minute Walk Test) and self-report measures (Prosthetic Limb Users Survey of Mobility, Activities-specific Balance Confidence Scale) using Spearman's rankorder correlations. Known-groups construct validity was assessed by comparing the Figureof-Eight Walk Test parameters based on anatomical level of amputation. Friedman's test and posthoc analysis was used to examine differences between the walking conditions within each group. Results: Cronbach's alpha coefficients of the Figure-of-Eight Walk Test parameters for all three conditions ranged from .89 to .99. The Figure-of-Eight Walk Test time and steps parameters demonstrated moderate to good correlation (r = -.50 to -.77) for performance-

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Section: Introductionmentioning

confidence: 99%

Assessing mobility for persons with lower limb amputation: the Figure-of-Eight Walk Test with the inclusion of two novel conditions

Schack

Mirtaheri

Steen

et al. 2019

Disability and Rehabilitation

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“…To assess the validity of this m5xSTS Test, we also administered the test to a large, diverse national sample of LLP users. The study sample was similar, both in demographic characteristics (e.g., age, gender, race, ethnicity) and amputation-related characteristics (e.g., level and etiology of amputation), to recent, large studies of LLP users in the United States [35,36]. However, we had more participants classified as MFCL K4 (40%) and fewer participants classified as MFCL K2 (14%) than are typically seen in routine prosthetics practices (i.e., 9-10% and 36-37%, respectively) [37,38].…”

Section: Discussionmentioning

confidence: 78%

Modifying the five-time sit-to-stand test to allow use of the upper limbs: Assessing initial evidence of construct validity among lower limb prosthesis users

et al. 2023

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The Five-time Sit-to-Stand (5xSTS) Test is a performance-based measure used by clinicians and researchers to assess the body functions needed to accomplish sit-to-stand transitions (e.g., lower limb strength, balance, and trunk control). The current requirements for performance of the 5xSTS Test (i.e., crossing arms over the chest) may not be appropriate for many, if not most lower limb prosthesis (LLP) users. The study aims were to (1) develop a modified five-time sit-to-stand (m5xSTS) Test protocol; (2) to examine initial evidence of known-groups construct validity among LLP users by comparing differences in performance by amputation level, amputation etiology, and functional level; and (3) to assess initial evidence of convergent construct validity by examining the correlations between m5xSTS performance with self-reported mobility (Prosthetic Limb Users Survey of Mobility (PLUS-M)), self-reported balance confidence (Activities-balance Confidence Scale (ABC)) and functional capability (comfortable walking speed). Three-hundred sixty-one LLP users participated in this cross-sectional study. The investigators developed a m5xSTS Test protocol that allows tested individuals to use different assistance strategies (i.e., use of upper limbs to push off thighs, push up from the armrests, or use a walker) when needed to perform the test. The investigators recorded m5xSTS Test times and assistance strategies. Significant differences in m5xSTS Test times were found between those who did and did not use an assistance strategy, as well as between participants grouped by different amputation level, etiology, and functional level. Significant moderate negative correlations were found between m5xSTS Test times and PLUS-M T-score (ρ = -0.42, p<0.001), ABC score (ρ = -0.42, p<0.001), and comfortable walking speed (ρ = -0.64, p<0.001), respectively. The m5xSTS Test allows LLP users to perform sit-to-stand transitions in a manner that accounts for their functional impairments, is consistent with post-amputation training, and is safe for the tested individual. Results from this study provide preliminary evidence of known groups and convergent construct validity for the m5xSTS Test with a large national sample of LLP users.

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“…Physical function, cognitive function, stress resilience, and employment were related to depression occurrence and rehabilitation outcomes in TLA patients [2 –4,7,8,14], because physical and cognitive function are important for prosthesis use, mobility, and participation in activities [14 –16], and high stress resilience helps amputees to develop new coping strategies to address their new role in society and in their employment [17]. However, in earlier studies, these characteristics were measured after amputation, and most studies focused on people with dysvascular amputation.…”

Section: Discussionmentioning

confidence: 99%

Risk of depression following traumatic limb amputation—a general population-based cohort study

Lindner

Montgomery

Hiyoshi

2019

Scand J Public Health

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Background: Individuals with traumatic limb amputation (TLA) may be at risk of depression, but evidence of increased depression after TLA from longitudinal studies has been limited. It is also unknown whether physical function, cognitive function, and employment prior to amputation affects depression risk. We aimed to examine longitudinal associations between TLA and depression in working age men, and to explore the role of pre-amputation occupational and individual characteristics. Methods: A Swedish national register-based cohort of 189,220 men born between 1952 and 1956, and who attended conscription assessments in adolescence, was followed from 1985 to 2009. Physical, cognitive, and psychological characteristics were measured at the conscription examination, and occupational information was obtained from the 1985 census. Main outcome measures were hospital inpatient and outpatient admissions for depression. Results: In total, 401 men underwent TLA; mean age at amputation was 42.5 years (SD 7.4). Cox regression produced an unadjusted hazard ratio (95% confidence interval) of 2.61 (1.62–4.21) for risk of subsequent depression associated with TLA compared with the general population. Adjustment for occupational, physical, cognitive, and psychological characteristics did not change the association much, producing a hazard ratio of 2.53 (1.57–4.08). Conclusions: TLA is associated with an increased risk of depression in men over more than two decades of follow up. Occupational and individual characteristics prior to amputation did not greatly change depression risk following amputation. We speculate that a coordinated combination of social support and medical management may help reduce persistent depression risk in men who experience amputation.

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Association of self-reported cognitive concerns with mobility in people with lower limb loss

Cited by 14 publications

References 54 publications

Assessing mobility for persons with lower limb amputation: the Figure-of-Eight Walk Test with the inclusion of two novel conditions

Assessing mobility for persons with lower limb amputation: the Figure-of-Eight Walk Test with the inclusion of two novel conditions

Modifying the five-time sit-to-stand test to allow use of the upper limbs: Assessing initial evidence of construct validity among lower limb prosthesis users

Risk of depression following traumatic limb amputation—a general population-based cohort study

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