Long-term activity in and among persons with transfemoral amputation

Halsne, Elizabeth G.; Waddingham, Matthew G.; Hafner, Brian J.

doi:10.1682/jrrd.2012.04.0066

Cited by 59 publications

(57 citation statements)

References 68 publications

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“…Previous studies focused on PA performance after LLA typically included multiple levels of amputation and/or causes of amputation [3–4,13]. Only one investigation specifically focused on PA performance in patients with transtibial dysvascular amputation [8].…”

Section: Introductionmentioning

confidence: 99%

Physical activity, ambulation, and comorbidities in people with diabetes and lower-limb amputation

Paxton¹,

Murray

Stevens-Lapsley

et al. 2016

J Rehabil Res Dev

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We characterized physical activity (PA) and its relation to physical function and number of comorbidities in people with diabetes and transtibial amputation (AMP), people with diabetes without AMP, and nondisabled adults without diabetes or AMP. Twenty-two individuals with type 2 diabetes mellitus (DM) and transtibial amputation (DM+AMP), 11 people with DM, and 13 nondisabled participants were recruited for this cross-sectional cohort study. Measures included PA volume and intensity, a Timed Up and Go test, a 2-min walk test, and number of comorbidities. The nondisabled group performed greater amounts of PA than the DM group, who performed greater amounts of PA than the DM+AMP group. PA was related to physical function in the DM group and in the DM+AMP group, whereas no such relationship existed in the nondisabled group. PA was not related to number of comorbidities in any group. These findings suggest the ability to walk may affect overall performance of PA. Alternately, PA may alleviate walking problems. This possibility is of interest because issues with walking may be modifiable by improved levels and intensity of PA. PA’s lack of relation to number of comorbidities suggests that factors beyond multiple morbidities account for group differences in PA.

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Section: Introductionmentioning

confidence: 99%

Physical activity, ambulation, and comorbidities in people with diabetes and lower-limb amputation

Paxton¹,

Murray

Stevens-Lapsley

et al. 2016

J Rehabil Res Dev

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“…Although individuals with TFA often receive a prosthesis (i.e., artificial limb) to replace amputated or absent anatomical structures, notable functional deficits remain. Specifically, TFA has been associated with decreased balance [1][2][3][4][5]; increased metabolic energy expenditure while walking [6][7][8][9]; decreased walking speed [7,[10][11]; increased frequency of stumbles and falls [12][13]; reduced activity level [14][15][16]; and difficulties negotiating uneven terrain, hills, and stairs [17][18][19][20]. These physical impairments and functional limitations likely contribute to the reduced health-related quality of life (HRQOL) [21][22][23][24] reported by people with TFA compared with nonamputee (nondisabled) norms [25][26].…”

Section: Introductionmentioning

confidence: 99%

Physical performance and self-report outcomes associated with use of passive, adaptive, and active prosthetic knees in persons with unilateral, transfemoral amputation: Randomized crossover trial

Hafner¹,

Askew²

2015

J Rehabil Res Dev

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Abstract-Prosthetic knees are a vital component in an artificial limb. Contemporary knees include passive (mechanical), adaptive (computerized), or active (motorized) control systems and have the potential to mitigate amputation-related functional impairments and activity limitations. A 14 mo randomized crossover trial was conducted. Participants (n = 12, mean age = 58 yr) were tested under three conditions: passive control (existing knee), adaptive control (Ossur Rheo Knee II), and active control (Ossur Power Knee II). Training and acclimation time were provided to participants in the adaptive and active knees. Outcome measures included indoor tests (Timed Up and Go test [TUG], stairs, and ramp), outdoor tests (walking course and perceived exertion), step activity monitor, self-report surveys (mobility, balance confidence, physical function, fatigue, and general health), and fall incidence. Mixed-effects linear regression modeling was used to evaluate data. Compared with passive control, adaptive control significantly improved comfortable TUG time (difference = 0.91 s, p = 0.001) and reported physical function (difference = 1.26 [T-score], p = 0.03). Active control significantly increased comfortable TUG, fast TUG, and ramp times (difference = 3.02, 2.66, and 0.96 s, respectively, all p < 0.03) and increased balance confidence (difference = 3.77, p = 0.003) compared with passive control. Findings suggest that adaptive knee control may enhance function compared with passive control but that active control can restrict mobility in middle-age or older users with transfemoral amputation.

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“…Monitoring activity for longer time intervals may reduce these problems, as suggested by Halsne et al . [49] . However, towards the goal of a sensitive variable for early identification of changes in socket fit, long-term activity monitoring may be impractical.…”

Section: Discussionmentioning

confidence: 99%

Effects of socket size on metrics of socket fit in trans-tibial prosthesis users

Sanders

Youngblood

Hafner

et al. 2017

Medical Engineering & Physics

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The purpose of this research was to conduct a preliminary effort to identify quantitative metrics to distinguish a good socket from an oversized socket in people with trans-tibial amputation. Results could be used to inform clinical practices related to socket replacement. A cross-over study was conducted on community ambulators (K-level 3 or 4) with good residual limb sensation. Participants were each provided with two sockets, a duplicate of their as-prescribed socket and a modified socket that was enlarged or reduced by 1.8 mm (~6% of the socket volume) based on the fit quality of the as-prescribed socket. The two sockets were termed a larger socket and a smaller socket. Activity was monitored while participants wore each socket for 4wk. Participants’ gait; self-reported satisfaction, quality of fit, and performance; socket comfort; and morning-to-afternoon limb fluid volume changes were assessed. Visual analysis of plots and estimated effect sizes (measure as mean difference divided by standard deviation) showed largest effects for step time asymmetry, step width asymmetry, anterior and anterior-distal morning-to-afternoon fluid volume change, socket comfort scores, and self-reported measures of utility, satisfaction, and residual limb health. These variables may be viable metrics for early detection of deterioration in socket fit, and should be tested in a larger clinical study.

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Long-term activity in and among persons with transfemoral amputation

Cited by 59 publications

References 68 publications

Physical activity, ambulation, and comorbidities in people with diabetes and lower-limb amputation

Physical activity, ambulation, and comorbidities in people with diabetes and lower-limb amputation

Physical performance and self-report outcomes associated with use of passive, adaptive, and active prosthetic knees in persons with unilateral, transfemoral amputation: Randomized crossover trial

Effects of socket size on metrics of socket fit in trans-tibial prosthesis users

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