Variables that Influence Basic Prosthetic Mobility in People With Non‐Vascular Lower Limb Amputation

Abstract

Background There exists a dearth of evidence on rehabilitation factors that influence prosthetic mobility in people with lower limb amputation (LLA). Examining variables that contribute to prosthetic mobility can inform rehabilitation interventions, providing guidance in developing more comprehensive care for these individuals. Objective To determine the influence of modifiable and non‐modifiable variables related to LLA and their impact on prosthetic mobility, using the International Classification of Functioning, Disability and Health (ICF) model. Secondarily, to determine if personal factors and self‐reported balance and mobility are predictive of Component timed‐up‐and‐go (cTUG) performance. Design Cross‐sectional study of a convenience sample. Setting National conference. Participants People (N=68) with non‐vascular causes of unilateral LLA. Methods Assessment of anthropometrics, mobility, bilateral hip extensor strength, hip range of motion, single limb balance, and self report measures. Lasso linear regression and extreme gradient boosting analyses were used to determine influence of variables on prosthetic mobility. Main Outcome Measure Timed performance of the cTUG. Results The following five variables were found to influence basic prosthetic mobility (P ≤ .05) in people with transtibial amputation: hip extensor strength, hip range of motion, single limb balance, waist circumference, and age. In the transfemoral cohort, number of comorbidities and waist circumference primarily influenced prosthetic mobility. Additionally, 66% of the variance in cTUG total time for the entire sample could be explained by simply regressing on level of amputation, number of comorbidities, age and Activities‐specific Balance Confidence scale score, all variables easily collected in a waiting room. Conclusion Variables that are modifiable with physical therapy intervention including hip extensor strength, hip range of motion, single limb balance, and waist circumference significantly influenced basic prosthetic mobility. These variables can be affected by targeted rehabilitation interventions and lifestyle changes. Level of Evidence II.

Self‐Efficacy and Social Support are Associated with Disability for Ambulatory Prosthesis Users After Lower‐Limb Amputation

“…For example, the number of comorbid conditions is negatively associated with physical function outcome for people with non-vascular LLA. 48 Further, history of stroke, peripheral vascular disease, or anxiety/panic disorders are associated with physical function outcomes in another retrospective cohort of nearly 600 people with LLA of any etiology. 9 In the present study, the number of comorbid conditions was used as a covariate in an analysis focused on identifying psychosocial factors influencing disability.…”

“…Although etiology is emphasized as an influential factor in rehabilitation post‐LLA, 2 literature suggests the influence of comorbid conditions may be more meaningful. For example, the number of comorbid conditions is negatively associated with physical function outcome for people with non‐vascular LLA 48 . Further, history of stroke, peripheral vascular disease, or anxiety/panic disorders are associated with physical function outcomes in another retrospective cohort of nearly 600 people with LLA of any etiology 9 .…”

Using theoretical frameworks to examine fall history and associated prosthetic mobility in people with nondysvascular lower limb amputation

“…Participants underwent testing of their hip strength, hip extension range of motion (ROM), and single-limb balance, all of which were contributing factors to their prosthetic mobility performance at various levels. 14 Hip extension ROM and hip extensor strength were measured in supine, consistent with previously described techniques. 14,26…”

“…14 Hip extension ROM and hip extensor strength were measured in supine, consistent with previously described techniques. 14,26…”

Biomedical Engineering of Prosthetic Limbs and Role of Physiotherapist About It

“…Artificial limb relaxation refers to the patient's thing and feels assessment of (elements of) the artificial limb, as impacted due to prosthesis' given's, characteristics, tone as equal aspects of the transtibial .Felling's about the trans radial are also done by the patient's mental condition, such as schizophrenia and mood disorder psychiatrically considerations;& personal traits, as like height and weight .prior experiences, coping, expectancies, and overall values, to name a few. (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21) The ability to set a transfemoral following a transtibial part (TTA) be circular to the recovery process. People with TTA who have a well fitted trans humeral can be much relaxed faster & perform good by every need of everyday destiny which have problems with adding application.…”