The Use of Physical Activity Outcomes in Rehabilitation Interventions for Lower Limb Amputees: A Systematic Review

Abstract

BACKGROUND: Interventions which have focused on improving the physical activity of individuals with lower limb amputation can be mostly categorized into behavioural-based and prosthetic-based interventions. The aim of this review was to assess the quality of these interventions, and to identify the key gaps in research in this field.
 METHODOLOGY: The databases of Scopus, Pubmed, Embase, Medline and Web of Science were searched between September and December of 2019 for articles relating to physical activity, amputees and interventions. Articles were assessed quantitively based on internal validity, external validity and intervention intensity. 
 FINDINGS: Sixteen articles (5 behavioural, 11 prosthetic) were assessed. Both approaches had comparable methodological quality and mixed efficacy for producing a significant change in physical activity outcomes. Almost all interventions used a simplistic measurement of activity as their outcome.
 CONCLUSIONS: There is an insufficient amount of studies to assess the overall efficacy of behavioural interventions in regard to how they impact on physical activity behaviour. However, the increase of quality of the methodology in the more recent studies could indicate that future interventions will retain similar levels of quality. Prosthetic interventions have shown no major improvement in efficacy compared to similar reviews and may need to utilise more advanced prosthetic components to attain significant changes in physical activity. Activity outcomes should expand into more complex activity measurements to properly understand the physical activity profile of people with lower limb amputation.
 Layman’s Abstract: The purpose of this review was to identify original research which tried to improve the physical activity behaviours of individuals with lower extremity amputation. Through multiple databases, the review article identified a mixture of 5 behavioural and 11 prosthetic-based interventions which aligned with the search criteria of the review. The behavioural-based interventions used behavioural change techniques controlled by healthcare professionals to try and promote a change in physical activity behaviours. The prosthetic-based interventions employed a prosthetic component, with the intention being that if the prosthetic component had superior design, the individual would feel more encouraged to be physically active. This review article concludes that, prosthetic interventions do not appear to have a consistent significant impact on the physical activity behaviours, and though behavioural interventions also had mixed efficacy, there were not enough interventions of their design to make a conclusive statement. 
 Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/33931/26330
 How To Cite: Jamieson A.G., Murray L., Buis A. The use of physical activity outcomes in rehabilitation interventions for lower limb amputees: A systematic review. Canadian Prosthetics & Orthotics Journal. 2020;Volume3, Issue1, No.2. https://doi.org/ 10.33137/cpoj.v3i1.33931
 Corresponding Author: Dr. Arjan Buis,Department of Biomedical Engineering, University of Strathclyde, Wolfson Centre, 106 Rottenrow, Glasgow, G4 0NW, Scotland, UK.E-Mail: arjan.buis@strath.ac.ukORCID: https://orcid.org/0000-0003-3947-293X

Enrichment of Wearable Sensor Data from Individuals with Lower Limb Amputation in a Free-Living Setting

“…Objective physical activity monitoring of lower limb amputees can be achieved using wearable sensors, however the literature has shown that simplistic objective monitoring (for instance, measuring step count or energy expenditure) is overwhelmingly favoured (Jamieson et al, 2020). For a more detailed analysis of activity, the implementation of machine learning algorithms to recognize wider varieties of activity is a logical solution.…”