From 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).
Am J Phys Med Rehabil. 2023 Sep 1;102(9):803-809. doi: 10.1097/PHM.0000000000002209. Epub 2023 Mar 15.
The aim of the study is to identify factors that may predict community participation among adults with lower limb amputation.
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.
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.
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.
本研究旨在确定可能预测下肢截肢成年人社区参与的因素。
本研究是对横断面数据集的二次分析,包括 126 名居住在社区的成年人,在门诊肢体丧失诊所就诊 1 年以上,单侧股骨-(n=44;平均年龄=59±14 岁)或胫骨水平截肢(n=82;平均年龄=59±14 岁)。使用社区融入问卷评估参与度。评估的因素包括人口统计学、合并症、根据 Houghton 量表的假肢使用情况、Socket Comfort 评分、辅助设备使用、跌倒史和一般实践活动问卷中的活动水平。此外,还包括活动特异性平衡信心量表中的平衡信心、运动能力指数中的移动能力、10 米步行测试中的快速和自我选择步行速度以及通过 Timed Up and Go 的功能性移动能力。
社区参与与多个因素相关(P≤0.050)。相关因素的逐步回归发现,没有周围神经病变和更高的自我报告的体力活动、平衡信心和假肢使用是最强的相关因素,共同解释了下肢截肢后社区参与的 50.1%的变异性。
研究结果确定了关键的可改变因素,可供未来旨在增强单侧股骨-或胫骨水平截肢成年人社区融入和参与的前瞻性研究考虑。