Risk Factors for Falls in Individuals With Lower Extremity Amputations During the Pre‐Prosthetic Phase: A Retrospective Cohort Study

Abstract

Background Falls in individuals with lower limb amputations (LLAs) pose significant health concerns. The literature is limited regarding falls during the preprosthetic phase of rehabilitation for persons with LLAs. Objective To determine the incidence of falls and identify factors associated with falls during the preprosthetic recovery phase. Design Retrospective chart audit. Setting Inpatient rehabilitation program. Participants Four hundred forty individuals with LLAs (age ± SD = 61.93 ± 14.53 years, 73.18% male) who attended inpatient rehabilitation from 26 July 2011 to 21 August 2017. Interventions Not applicable. Main Outcome Measurements The number of self‐reported falls was recorded from the time of surgery to admission for inpatient rehabilitation. Outcomes of interest were any fall (1+ fall) and recurrent falls (2+ falls). A retrospective chart audit was performed on consecutive admissions to an inpatient rehabilitation program. Results The incidence of falls was 8.37 per 1000 patient‐days. Falls were sustained by 60.9% of the sample. Unilateral transtibial amputation was independently associated with an increased risk of recurrent falls (relative risk [RR] 1.59, 95% confidence interval [CI] 1.13–2.23, P = .008). Diabetes mellitus was independently associated with an increased risk of any fall (RR 1.18, 95% CI 1.01–.38, P = .03). Finally, bilateral transtibial amputation was independently associated with a reduced risk of any fall (RR 0.59, 95% CI 0.39–0.90, P = .014). Conclusions Consistent with the current literature, diabetes mellitus and a unilateral transtibial amputation were risk factors for falling, whereas a bilateral transtibial amputation and increasing age presented new findings as factors associated with decreased falling. Level of Evidence III.

Gait Alteration in Individual with Limb Loss: The Role of Inertial Sensors

“…According to the World Health Organization (WHO), falls are the second leading cause of accidental death [ 74 ]. Following the amputation of a lower limb, the risk of falls is increased [ 75 , 76 ].…”

Clinical evaluation of fall risk in older adults who use lower‐limb prostheses: A scoping review

“…The definition of older adults in this review was a mean participant age of 55 years which ultimately influenced which articles were included. Also, factors previously associated with falls in this population, such as microprocessor knees (MPKs), 61 inpatient falls, fall-related injuries, and near-falls were outside the scope of this review, 8,9,62,63 but are prevalent and should be examined in future work. The observational nature of studies included in this review should also be noted, and research is needed to determine if using these assessments could consistently decrease falls.…”