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Published on: May 8, 2014
Key Modifiable Factors in Community Participation Among Adults With Lower Limb Amputation
Jaclyn Megan Sions1, Mayank Seth, Ryan Todd Pohlig
1From the Delaware Limb Loss Studies, Department of Physical Therapy, University of Delaware, Newark, Delaware (JMS, MS, SJS); University of Delaware, Biostatistics Core, Newark, Delaware (RTP); Independence Prosthetics-Orthotics, Inc, Newark, Delaware (SJS, JRH); and Christiana Spine Center, Newark, Delaware (FBS).
Objective:
The aim of the study is to identify factors that may predict community participation among adults with lower limb amputation.
Design:
This study is a secondary analysis of a cross-sectional data set, including 126 community-dwelling adults, ≥1 yr after unilateral transfemoral- ( n = 44; mean age = 59 ± 14 yrs) or transtibial-level amputation ( n = 82; mean age = 59 ± 14 yrs) 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.
Results:
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.
Conclusions:
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.
