Factors affecting activities of daily living, physical balance, and prosthesis adjustment in non-traumatic lower limb amputees

Abstract

Objectives This study aims to identify the factors affecting the activities of daily living, balance, and prosthesis satisfaction in patients with non-traumatic lower limb amputation (LLA). Patients and methods This cross-sectional study included a total of 195 patients (120 males, 75 females; mean age 65.9±11.6 years; range, 40 to 90 years) who underwent LLA between January 2009 and April 2017. All patients were evaluated in terms of age, sex, amputation etiology, side, level, comorbidity, length of hospital stay, prosthesis adjustment, ambulation level, functional outcome, and complications. Prosthesis adjustment, physical balance ability, and daily living activities were assessed using the Turkish versions of the Trinity Amputation and Prosthesis Experience Scales (TAPES), Berg Balance Scale (BBS), and Nottingham Extended Activities of Daily Living Scale (NEADLS), respectively. Results There was no significant difference between male and female patients in terms of prosthesis and amputation adaptation, physical balance, and activities of daily living. The BBS, TAPES, and NEADLS scores were lower in the patients aged over 65 years (p<0.001, p<0.001, and p<0.001, respectively). Prosthesis and amputation adaptation, physical balance, and daily living activities were also worse in this age group. Transfemoral amputees had lower BBS, TAPES, and NEADLS scores than the transtibial amputees (p=0.009, p=0.020, and p=0.004, respectively). Prosthesis and amputation adaptation, physical balance, and daily living activities were worse in the transfemoral amputees. Conclusion Age and amputation level affect physical balance, prosthesis satisfaction, and daily living activities after non-traumatic LLA. Therefore, orthopedic surgeons and physical therapists should conduct a multidisciplinary evaluation, particularly in patients aged over 65 years and in transfemoral amputees to improve outcomes.

Survey of physical activity in persons with limb loss during the COVID-19 pandemic in the United States

“…This is due to the increased energy expenditure, strength, and balance required to functionally use a prosthesis. 15,28 Because prolonged periods of inactivity can lower cardiovascular fitness, decrease strength and flexibility, and lessen the body's ability to promptly respond to perturbations to balance, persons with limb loss and other vulnerable populations are at risk of developing impairments that could result in falls or disuse of the prosthesis. 6,7 Therefore, developing guidelines and advisement for future scenarios like the COVID-19 pandemic is necessary to help educate persons with limb loss to prevent the confusion and inactivity that was experienced during the current situation.…”

“…Balance confidence, fall risk, and other gait challenges are more common in individuals with lower limb loss, especially bilateral limb loss, thereby making strength training and aerobic conditioning in the home or in the open outdoors more difficult. 15,34,35 The use of exercise equipment, such as weight machines, recumbent bicycles, and treadmills with rails and slow set speeds readily provide the means for many individuals to strengthen and aerobically condition with greater safety, stability, and without the fear of falling or increasing fall risk. [35][36][37][38][39] Regarding the psychological and social benefits mentioned by participants for doing exercise in gyms or pools, two primary factors have been reported to be significant in the perception of physical fitness and emotional well-being: inspiration of other members of a group fitness program or its instructor and the belief that group exercise indeed held positive benefits specific to the individual.…”

Effect Of Use Of Flexible Transfemoral Prosthesis On Level Of Independence In Performing Daily Activities Of Transfemoral Amputee

“…In the research of Varekova, et al, (2018), it was shown that by consuming transfemoral prosthesis, the majority of the patients had accessible washrooms in units, could ambulate independently, were confident after provision of prosthesis and were spared by their units for timely follow-up. In research, Karaali et al, (2020) stated that there was no significant difference between male and female patients in terms of prosthesis and amputation adaptation, physical balance, and activities of daily living.…”

Reliability and Validity of the Adapted Persian Version of the Physical Activity Scale for Individuals With Physical Disabilities

“…Some authors have shown that the level of amputation can affect the level of physical activity of persons with LLA [42]. Those with transtibial amputation walk more steps per day than those with transfemoral amputation [42]. However, regarding the level of amputation, the P-PASIPD has been unable to discriminate between participants.…”

“…Hence, indoor activities are managed mainly by women, and men are primarily engaged in outdoor activities. Some authors have shown that the level of amputation can affect the level of physical activity of persons with LLA [42]. Those with transtibial amputation walk more steps per day than those with transfemoral amputation [42].…”