Real-World Walking Performance of Individuals with Lower-Limb Amputation Classified as Medicare Functional Classification Level 2 and 3

Arch, Elisa S.; Erol, Ozan; Bortz, Connor; Madden, Chelsea; Galbraith, Matthew; Rossi, Anthony; Lewis, Jessica; Higginson, Jill S.; Buckley, Jenni M.; Horne, John Robert

doi:10.1097/jpo.0000000000000088

Cited by 5 publications

(8 citation statements)

References 9 publications

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“… Neither daily step count nor 6MWT were responsive to changes in prosthetic feet, so it is not recommended that these measures are used to assess outcomes for different prosthetic feet. Comparing populations Arch (2016) [ 89 ] Real-world walking performance of individuals with lower-limb amputation classified as Medicare Functional Classification Level 2 and 3 27 participants (10 BK and 1 AK at K2, and 10 BK and 6 AK at K3) Fitbit One (P. Ankle) Activity level – steps/day (7 days) Investigate community walking performance measures (step count, amount of activity, and activity intensity) for individuals with unilateral lower-limb amputation classified as K2 and K3. The K2 group had a slower self-selected walking speed, walked a shorter distance in 6 min, and had a lower total step count, than those classified as K3.…”

Section: Resultsmentioning

confidence: 99%

“…Seventeen papers compared activity levels of lower-limb prosthesis users to clinical scores . The most frequently used clinical score that was compared with measured everyday activity was the K-level score [ 30 , 43 , 44 , 49 – 51 , 54 , 55 , 57 , 87 , 89 , 94 , 95 ]. There was good correlation between the K-level score and the number of steps taken in everyday life [ 30 , 43 , 44 , 49 , 54 , 55 ].…”

Section: Resultsmentioning

confidence: 99%

“…The 7 papers comparing lower-limb prosthesis user populations ranged in topic. One compared those with an amputation to an anatomically intact control group [ 90 ], one compared those with diabetes to anatomically intact participants with and without diabetes [ 96 ], some studies compared different K-levels [ 89 , 95 ], or amputation levels [ 28 , 93 ], and one compared individuals with a history of falls to those without [ 94 ]. The main findings were that prosthesis users were less physically active than anatomically intact controls, and individuals with vascular disease, above-knee amputation or lower K-levels were less physically active, compared to those with traumatic injury, below-knee amputation, or higher K-levels, respectively.…”

Section: Resultsmentioning

confidence: 99%

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Technology for monitoring everyday prosthesis use: a systematic review

Chadwell

Diment

Micó-Amigo

et al. 2020

J NeuroEngineering Rehabil

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Background: Understanding how prostheses are used in everyday life is central to the design, provision and evaluation of prosthetic devices and associated services. This paper reviews the scientific literature on methodologies and technologies that have been used to assess the daily use of both upper-and lower-limb prostheses. It discusses the types of studies that have been undertaken, the technologies used to monitor physical activity, the benefits of monitoring daily living and the barriers to long-term monitoring, with particular focus on low-resource settings. Methods: A systematic literature search was conducted in PubMed, Web of Science, Scopus, CINAHL and EMBASE of studies that monitored the activity of prosthesis users during daily-living. Results: Sixty lower-limb studies and 9 upper-limb studies were identified for inclusion in the review. The first studies in the lower-limb field date from the 1990s and the number has increased steadily since the early 2000s. In contrast, the studies in the upper-limb field have only begun to emerge over the past few years. The early lowerlimb studies focused on the development or validation of actimeters, algorithms and/or scores for activity classification. However, most of the recent lower-limb studies used activity monitoring to compare prosthetic components. The lower-limb studies mainly used step-counts as their only measure of activity, focusing on the amount of activity, not the type and quality of movements. In comparison, the small number of upper-limb studies were fairly evenly spread between development of algorithms, comparison of everyday activity to clinical scores, and comparison of different prosthesis user populations. Most upper-limb papers reported the degree of symmetry in activity levels between the arm with the prosthesis and the intact arm. Conclusions: Activity monitoring technology used in conjunction with clinical scores and user feedback, offers significant insights into how prostheses are used and whether they meet the user's requirements. However, the cost, limited battery-life and lack of availability in many countries mean that using sensors to understand the daily use of prostheses and the types of activity being performed has not yet become a feasible standard clinical practice. This review provides recommendations for the research and clinical communities to advance this area for the benefit of prosthesis users.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Technology for monitoring everyday prosthesis use: a systematic review

Chadwell

Diment

Micó-Amigo

et al. 2020

J NeuroEngineering Rehabil

View full text Add to dashboard Cite

show abstract

“…ActiGraph (ActiGraph, Pensacola, USA) [29,31,32,39,41,43,45,47,53,70,75,[80][81][82][83]92,105,109], FitBit (FitBit, San Francisco, USA) [34,40,52,76,108,117], and activPAL (PAL Technologies, Glasgow, Scotland) [26,36,37,68,91,103,104].…”

Section: Inclusion Of Sources Of Evidencementioning

confidence: 99%

Reported Outcome Measures in Studies of Real-World Ambulation in People with a Lower Limb Amputation: A Scoping Review

Mellema

Gjøvaag

2022

Sensors

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Background: The rapidly increasing use of wearable technology to monitor free-living ambulatory behavior demands to address to what extent the chosen outcome measures are representative for real-world situations. This scoping review aims to provide an overview of the purpose of use of wearable activity monitors in people with a Lower Limb Amputation (LLA) in the real world, to identify the reported outcome measures, and to evaluate to what extent the reported outcome measures capture essential information from real-world ambulation of people with LLA. Methods: The literature search included a search in three databases (MEDLINE, CINAHL, and EMBASE) for articles published between January 1999 and January 2022, and a hand-search. Results and conclusions: 98 articles met the inclusion criteria. According to the included studies’ main objective, the articles were classified into observational (n = 46), interventional (n = 34), algorithm/method development (n = 12), and validity/feasibility studies (n = 6). Reported outcome measures were grouped into eight categories: step count (reported in 73% of the articles), intensity of activity/fitness (31%), type of activity/body posture (27%), commercial scores (15%), prosthetic use and fit (11%), gait quality (7%), GPS (5%), and accuracy (4%). We argue that researchers should be more careful with choosing reliable outcome measures, in particular, regarding the frequently used category step count. However, the contemporary technology is limited in providing a comprehensive picture of real-world ambulation. The novel knowledge from this review should encourage researchers and developers to engage in debating and defining the framework of ecological validity in rehabilitation sciences, and how this framework can be utilized in the development of wearable technologies and future studies of real-world ambulation in people with LLA.

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“…The 7 papers comparing lower-limb prosthesis user populations ranged in topic. One compared those with an amputation to an anatomically intact control group, 90 one compared amputees with diabetes to anatomically intact participants with and without diabetes, 96 some studies compared amputees with different K-levels, 89,95 or amputation levels, 28,93 and one compared amputees with a history of falls to those without. 94 The main findings were that amputees were less physically active than the anatomically intact controls, and amputees with vascular disease, above-knee amputation or lower K-levels were less physically active, compared to below-knee amputees, to those with traumatic injury and to those with higher K-levels.…”

mentioning

confidence: 99%

Technology for monitoring everyday prosthesis use: a systematic review

Chadwell¹,

Diment²,

Amigo³

et al. 2020

Preprint

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BackgroundUnderstanding how prostheses are used in everyday life is central to the design, provision and evaluation of prosthetic devices and associated services. This paper reviews the scientific literature on methodologies and technologies that have been used to assess the daily use of both upper- and lower-limb prostheses. It discusses the types of studies that have been undertaken, the technologies used to monitor physical activity, the benefits of monitoring daily living and the barriers to long-term monitoring.MethodsA systematic literature search was conducted in PubMed, Web of Science, Scopus, CINAHL and EMBASE of studies that monitored the activity of prosthesis-users during daily-living.Results60 lower-limb studies and 9 upper-limb studies were identified for inclusion in the review. The first studies in the lower-limb field date from the 1990s and the number has increased steadily since the early 2000s. In contrast, the studies in the upper-limb field have only begun to emerge over the past few years. The early lower-limb studies focused on the development or validation of actimeters, algorithms and/or scores for activity classification. However, most of the recent lower-limb studies used activity monitoring to compare prosthetic components. The lower-limb studies mainly used step-counts as their only measure of activity, focusing on the amount of activity, not the type and quality of movements. In comparison, the small number of upper-limb studies were fairly evenly spread between development of algorithms, comparison of everyday activity to clinical scores, and comparison of different prosthesis user populations. Most upper-limb papers reported the degree of symmetry in activity levels between the arm with the prosthesis and the intact arm.ConclusionsActivity monitoring technology used in conjunction with clinical scores and user feedback, offers significant insights into how prostheses are used and whether they meet the user’s requirements. However, the cost, limited battery-life and lack of availability in many countries mean that using sensors to understand the daily use of prostheses and the types of activity being performed has not yet become a feasible standard clinical practice. This review provides recommendations for the research and clinical communities to advance this area for the benefit of prosthesis users.

show abstract

Real-World Walking Performance of Individuals with Lower-Limb Amputation Classified as Medicare Functional Classification Level 2 and 3

Cited by 5 publications

References 9 publications

Technology for monitoring everyday prosthesis use: a systematic review

Technology for monitoring everyday prosthesis use: a systematic review

Reported Outcome Measures in Studies of Real-World Ambulation in People with a Lower Limb Amputation: A Scoping Review

Technology for monitoring everyday prosthesis use: a systematic review

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