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Risk Factors for Falls in Individuals With Lower Extremity Amputations During the Pre-Prosthetic Phase: A
Kimberly Vu1, Michael W C Payne2, Susan W Hunter3
1School of Health Studies, University of Western Ontario, London, ON, Canada.
Background:
Falls in individuals with lower limb amputations (LLAs) pose significant health concerns. The literature is limited regarding falls during the preprosthetic phase of rehabilitation for persons with LLAs.
Objective:
To determine the incidence of falls and identify factors associated with falls during the preprosthetic recovery phase.
Design:
Retrospective chart audit.
Setting:
Inpatient rehabilitation program.
Participants:
Four hundred forty individuals with LLAs (age ± SD = 61.93 ± 14.53 years, 73.18% male) who attended inpatient rehabilitation from 26 July 2011 to 21 August 2017.
Interventions:
Not applicable.
Main Outcome Measurements:
The number of self-reported falls was recorded from the time of surgery to admission for inpatient rehabilitation. Outcomes of interest were any fall (1+ fall) and recurrent falls (2+ falls). A retrospective chart audit was performed on consecutive admissions to an inpatient rehabilitation program.
Results:
The incidence of falls was 8.37 per 1000 patient-days. Falls were sustained by 60.9% of the sample. Unilateral transtibial amputation was independently associated with an increased risk of recurrent falls (relative risk [RR] 1.59, 95% confidence interval [CI] 1.13-2.23, P = .008). Diabetes mellitus was independently associated with an increased risk of any fall (RR 1.18, 95% CI 1.01-.38, P = .03). Finally, bilateral transtibial amputation was independently associated with a reduced risk of any fall (RR 0.59, 95% CI 0.39-0.90, P = .014).
Conclusions:
Consistent with the current literature, diabetes mellitus and a unilateral transtibial amputation were risk factors for falling, whereas a bilateral transtibial amputation and increasing age presented new findings as factors associated with decreased falling.
Level Of Evidence:
III.
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