Journal of Rehabilitation Research & Development (JRRD)

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Volume 53 Number 5, 2016
   Pages 551 — 560

Abstract — Balance confidence and activity of community-dwelling patients with transtibial amputation

Alena Mandel, MScOT;1 Kailan Paul, MScOT;1 Ruby Paner, BSc;2 Michael Devlin, MD, FRCPC;3 Steven Dilkas, MD, FRCPC;3–4 Tim Pauley, MSc2*

1Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada; 2Nathan Clinical Research Institute, West Park Healthcare Centre, Toronto, ON, Canada; 3Amputee Rehabilitation Services, West Park Healthcare Centre, Toronto, ON, Canada; 4Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Toronto, ON, Canada

Abstract — The purpose of this study was to examine the relationship between balance confidence and community-based physical activity. Twenty-two community-dwelling patients with right or left unilateral transtibial amputation who reported no falls in the past 6 mo completed the Activities-Specific Balance Confidence Scale (ABC) and wore a StepWatch Activity Monitor for 7 consecutive d in the community. Subjects were subsequently stratified as low (<3,000 steps/d) or high (>/=3,000 steps/d) activity groups. Balance confidence was significantly lower among the low activity weekday group (LAG) (70.8 +/– 12.0 vs 88.9 +/– 8.7, t(20) = 3.97, p = 0.001). Further, correlation analysis revealed a positive correlation between ABC score and step total (r = 0.55, p < 0.01). It is unknown whether the LAG limited ambulation as an intentional strategy of fall-risk avoidance. Although clinicians routinely inquire about falls in the community among patients with lower-limb amputation, the results of this study emphasize the importance of contextualizing recent fall history relative to activity level. Clinicians can use this contextual information when considering the inclusion of appropriate fall-risk mediation strategies relative to activity levels and counseling patients on the benefits of physical exercise for maintaining functional capacity and general health.

Key Words: ambulation, amputation, amputees, artificial limbs, balance confidence, fall risk, lower limb, mobility capacity, physical activity, prosthesis.


View HTML ¦ View PDF ¦ Contents Vol. 53, No.5

This article and any supplementary material should be cited as follows:
Mandel A, Paul K, Paner R, Devlin M, Dilkas S, Pauley T. Balance confidence and activity of community-dwelling
patients with transtibial amputation. J Rehabil Res Dev. 2016;53(5):551–60.
http://dx.doi.org/10.1682/JRRD.2015.03.0044
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