Kinematic differences exist between transtibial amputee fallers and non-fallers during downwards step transitioning

Vanicek, Natalie; Strike, Siobhán; Polman, Remco

doi:10.1177/0309364614532867

Cited by 5 publications

(7 citation statements)

References 25 publications

(80 reference statements)

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“…While people with transtibial amputations achieve higher functional levels, they also engage in more activities that can lead to increased risk and more injurious falls (Wong et al 2015 ; Jayakaran et al 2014 ). This is illustrated by the fact that people with transtibial amputation, especially those that tend to fall more frequently, walk faster than those who do not fall (Vanicek et al 2015 ).…”

Section: Discussionmentioning

confidence: 99%

Factors associated with the likelihood of fall-related injury among people with lower limb loss

Chihuri

Wong

2018

Inj. Epidemiol.

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BackgroundPeople with lower limb loss that live in the community fall at a rate that exceeds that of other vulnerable populations such as hospitalized elderly people. Past research in a small single state study has identified factors associated with fall-related injury. The purpose of this study was to use a larger multistate sample of people with lower limb loss living in community settings to evaluate factors associated with fall-related injury in a multivariable model.MethodThis retrospective cohort study included community-dwelling people with lower limb loss participating in wellness-walking programs in 6 states within the United States. Fall-related injury was considered injury sustained during a fall to the ground that required medical care. Pearson’s Chi-squared test and student’s t-test were used for descriptive statistics. Odds ratios and 95% confidence intervals from multivariable logistic regression modelling were used to estimate the likelihood of fall-related injuries.ResultsOf the 303 subjects recruited, 257 (84.8%) were included in the analyses. Overall, 45 subjects (17.5%) reported at least a single fall-related injury. Most subjects reported two or more falls within the previous 12 months (N = 161, 63.1%), were male (N = 177, 68.9%), and were White (N = 212, 83.8%). Most falls were associated with gait (44.5%), activities of daily living (ADL, 15.7%), or ramps and/or stairs (12%). The likelihood of fall-related injury was elevated among females versus males (OR = 2.90, 95% CI 1.35, 6.24), people of non-White versus White race (OR = 4.79, 95% CI 1.06, 21.76), people with vascular amputations due to peripheral artery disease or diabetes versus non-vascular amputations (OR = 2.22, 95% CI 1.04, 4.73) and people with transtibial versus transfemoral amputations (OR = 2.32, 95% CI 1.01, 4.89).DiscussionResults of this study show that the likelihood of fall-related injury was significantly higher among women, non-White race, people with vascular and transtibial amputations. The results from this study were largely consistent with results from the prior multivariable fall-related injury model.ConclusionThe results highlight the association of female sex, non-White race, vascular and transtibial amputations with the likelihood of fall-related injury. Future studies may use the study findings to develop educational fall prevention programs for women, minorities, and people with vascular etiology and transtibial amputations.

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Section: Discussionmentioning

confidence: 99%

Factors associated with the likelihood of fall-related injury among people with lower limb loss

Chihuri

Wong

2018

Inj. Epidemiol.

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“…Further, no spatiotemporal or kinematic walking parameters were found to be significantly associated with falls, although this relationship was only examined in two articles suggesting more research is warranted. Multiple kinetic parameters were able to significantly distinguish between non‐faller and fallers during level ground walking, 46 stair ascent, 47 and stair descent 48 . However, these parameters were only found in single studies.…”

Section: Discussionmentioning

confidence: 95%

“…Multiple kinetic parameters were able to significantly distinguish between non-faller and fallers during level ground walking, 46 stair ascent, 47 and stair descent. 48 However, these parameters were only found in single studies. These findings suggest that no clinical outcome measure or gait parameter alone is effective at determining fall risk in this population.…”

Section: Discussionmentioning

confidence: 99%

“…For example, the findings of this review suggest the time taken to negotiate stairs could distinguish fallers from nonfallers. 47,48 Further research is needed to better define gait parameters in multiple activities of daily living that are associated with falling and define these in combination with clinical outcome measures. If findings are generalizable to a larger number of older adults who use lower-limb prostheses, a combination of assessments could define a clinically feasible evidence-based clinical protocol to screen fall risk in this population.…”

Section: Discussionmentioning

confidence: 99%

“…Nineteen articles were included in this review. 5,10,[40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56] Figure 1 depicts the inclusion process, and Supplemental Table 1 summarizes the included articles. Articles included ≤10 participants (n = 3, where n is the number of articles), 16-30 participants (n = 8), 31-50 participants (n = 5), and 51 or more participants (n = 3).…”

Section: Article Demographicsmentioning

confidence: 99%

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Clinical evaluation of fall risk in older adults who use lower‐limb prostheses: A scoping review

Finco

Sumien

Moudy

2023

J American Geriatrics Society

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Background No reviews or evidence‐based clinical protocols exist to evaluate fall risk in older adults who use lower‐limb prostheses, despite falls being prevalent and costly in this population. This scoping review sought to determine assessments, defined as clinical outcome measures and gait parameters, associated with fall risk in this population to determine if a systematic review is warranted and help inform an evidence‐based clinical protocol. Methods Google Scholar, PubMed, and Scopus were searched on April 19th, 2022 to include peer‐reviewed original research. Included articles reported relationships between falls and clinical outcome measures or gait parameters in older adults who use transtibial or transfemoral prostheses. Clinical outcome measures included self‐reported questionnaires and functional mobility tests. Gait parameters included spatiotemporal, kinematic, and kinetic data during walking and stair negotiation. Results Nineteen articles were included. Clinical outcome measure scores, gait parameter data, and cutoff scores by fall status (nonfallers, single fallers, recurrent fallers) were summarized. Six articles determined clinical outcome measures that had statistically significant associations with falls, and two articles determined gait parameters that had statistically significant associations with falls. Conclusions The majority of articles found no clinical outcome measure or gait parameter alone was effective at identifying fall risks in this population. Future research should evaluate a combination of assessments and collect prospective fall data to move towards establishing an evidence‐based protocol to evaluate fall risk in older adults using lower‐limb prostheses.

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Gait During Real-World Challenges: Gait Initiation, Gait Termination, Acceleration, Deceleration, Turning, Slopes, and Stairs

Orendurff¹

2018

Handbook of Human Motion

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Kinematic differences exist between transtibial amputee fallers and non-fallers during downwards step transitioning

Abstract: Study Design: Cross-sectional study.Background: Stair negotiation is biomechanically more challenging that level gait.

Cited by 5 publications

References 25 publications

Factors associated with the likelihood of fall-related injury among people with lower limb loss

Factors associated with the likelihood of fall-related injury among people with lower limb loss

Clinical evaluation of fall risk in older adults who use lower‐limb prostheses: A scoping review

Gait During Real-World Challenges: Gait Initiation, Gait Termination, Acceleration, Deceleration, Turning, Slopes, and Stairs

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