Can we predict community participation after amputation? Researchers from the Delaware Limb Loss Studies, Department of Physical Therapy, at the University of Delaware in Newark, sought to answer that question using a secondary analysis of a cross-sectional data set to identify factors that may predict community participation among adults with lower limb amputation.
The study included 126 community-dwelling adults who were ≥1 yr after unilateral transfemoral- (n = 44; mean age = 59 ± 14 yrs) or transtibial-level amputation (n = 82; mean age = 59 ± 14 yrs) and were seen in an outpatient limb loss clinic. Participation was assessed with the Community Integration Questionnaire. Factors, that is, demographics, comorbidities, prosthesis use per the Houghton Scale, Socket Comfort Score, assistive device use, falls history, and activity level per General Practice Physical Activity Questionnaire were evaluated. Moreover, balance confidence per the Activities-Specific Balance Confidence Scale, mobility per the Locomotor Capabilities Index, fast and self-selected gait speed per 10-meter walk tests, and functional mobility via Timed Up and Go were also included.
The team found that community participation was correlated with several factors (P ≤ 0.050). Stepwise regression of correlated factors found absence of peripheral neuropathy and greater self-reported physical activity, balance confidence, and prosthesis use, as the strongest correlates, collectively explaining 50.1% of the variance in community participation post-lower limb amputation.
The authors concluded that their findings identify key modifiable factors for consideration in future prospective research seeking to enhance community reintegration and participation among adults living with a unilateral transfemoral- or transtibial-level amputation.
Source: Sions JM, Seth M, Pohlig RT, Stauffer SJ, Horne JR, Sarlo FB. Key Modifiable Factors in Community Participation Among Adults With Lower Limb Amputation. Am J Phys Med Rehabil. 2023;102(9):803-809. doi: 10.1097/PHM.0000000000002209.
