Pain, Balance-Confidence, Functional Mobility, and Reach Are Associated With Risk of Recurrent Falls Among Adults With Lower-Limb Amputation
Date
2023-12-10
Journal Title
Journal ISSN
Volume Title
Publisher
Archives of Rehabilitation Research and Clinical Translation
Abstract
Objective
The study evaluated whether pain intensity and extent, balance-confidence, functional mobility, and balance (eg, functional reach) are potential risk factors for recurrent falls among adults with a lower-limb amputation.
Design
Cross-sectional study.
Setting
Research laboratory.
Participants
Eighty-three adults with unilateral lower-limb amputation that occurred >1 year prior (26 transfemoral- and 57 transtibial-level amputation; 44.6% women; 51.8% traumatic cause of amputation; N=83).
Intervention
Not applicable.
Main Outcome Measures
Participants reported on the number of falls in the past year, as well as pain intensity in the low back, residual, and sound limbs. Balance-confidence (per the Activities-Specific Balance-Confidence Scale [ABC]), functional mobility (per the Prosthetic Limb Users Survey of Mobility ([PLUS-M]), and balance (per the Functional Reach and modified Four Square Step Tests) were obtained.
Results
After considering non-modifiable covariates, greater extent of pain, less balance-confidence, worse self-reported mobility, and reduced prosthetic-side reach were factors associated with recurrent fall risk. Adults reporting pain in the low back and both lower-limbs had 6.5 times the odds of reporting recurrent falls as compared with peers without pain. A 1-point increase in ABC score or PLUS-M T score, or 1-cm increase in prosthetic-side reaching distance, was associated with a 7.3%, 9.4%, and 7.1% decrease in odds of reporting recurrent falls in the past year, respectively.
Conclusions
Of the 83 adults, 36% reported recurrent falls in the past year. Presence of pain in the low back and both lower-limbs, less balance-confidence, worse PLUS-M score, and less prosthetic-side reaching distance were identified as modifiable factors associated with an increased odd of recurrent falls.
Description
This article was originally published in Archives of Rehabilitation Research and Clinical Translation. The version of record is available at: https://doi.org/10.1016/j.arrct.2023.100309. © 2023 The Authors. Published by Elsevier Inc. on behalf of American Congress of Rehabilitation Medicine
Keywords
accidental falls, amputees, mobility limitation, postural balance, prostheses and implants
Citation
Seth, Mayank, John Robert Horne, Ryan Todd Pohlig, and Jaclyn Megan Sions. “Pain, Balance-Confidence, Functional Mobility, and Reach Are Associated With Risk of Recurrent Falls Among Adults With Lower-Limb Amputation.” Archives of Rehabilitation Research and Clinical Translation 5, no. 4 (December 2023): 100309. https://doi.org/10.1016/j.arrct.2023.100309.