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Validating a fear-of-falling-related activity avoidance scale in lower limb prosthesis users
Noah J Rosenblatt1, Matthew J Major2,3,4, Bobak Manesh1
1Center for Lower Extremity Ambulatory Research (CLEAR) at the Dr. William M. Scholl College of Podiatric Medicine, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA.
PM & R : the Journal of Injury, Function, and Rehabilitation
|August 26, 2023
Summary
Fear of falling (FoF) is common in lower limb prosthesis users (LLPUs) and impacts rehabilitation. The modified Survey of Activities and FoF in the Elderly (mSAFE) scale shows validity in assessing FoF-related activity avoidance in LLPUs.
Area of Science:
- Rehabilitation Science
- Prosthetics and Orthotics
- Psychological Health
Background:
- Fear of falling (FoF) is prevalent among lower limb prosthesis users (LLPUs), potentially hindering rehabilitation outcomes.
- Activity avoidance due to FoF can exacerbate negative consequences, necessitating valid measurement tools.
- Existing data on FoF-related activity avoidance scales in LLPUs are limited.
Purpose of the Study:
- To evaluate the convergent, discriminant, and known-group construct validity of the modified Survey of Activities and FoF in the Elderly (mSAFE) specifically for LLPUs.
- To assess the feasibility of reducing the mSAFE scale's length without compromising its construct validity.
Main Methods:
- An online survey was administered to 59 individuals with lower limb amputations (transtibial or transfemoral) with at least six months of prosthesis use.
- Participants completed the mSAFE, alongside measures of FoF, activity avoidance, and related/unrelated constructs.
- Validity was assessed using t-tests for known-group comparisons and correlations for convergent/discriminant validity.
Main Results:
- The mSAFE demonstrated significant convergent validity (correlation coefficients |0.440-0.825|) and known-group construct validity (p < .021).
- Evidence for discriminant validity was observed, with non-significant associations in two out of three correlations.
- A shortened 6-item mSAFE version yielded similar validity results to the full scale.
Conclusions:
- The mSAFE scale is a valid instrument for measuring fear-of-falling-related activity avoidance in lower limb prosthesis users.
- A reduced 6-item mSAFE scale may be a practical alternative when brevity is required, offering similar validity.
- These findings support the use of the mSAFE in clinical and research settings involving LLPUs.
