Relevance of medical comorbidities for functional mobility in people with limb loss: retrospective explanatory models for a clinical walking measure and a patient-reported functional outcome.
Study Goal
The researchers aimed to determine how modifiable and non-modifiable factors influence prosthetic functional mobility, using both patient-reported and performance-based measures.
Results Summary
The study found that both modifiable (balance ability, confidence, prosthesis use) and non-modifiable factors (sex, amputation cause, surgical level) explained variance in functional mobility. Performance-based walking was linked to balance and confidence, while patient-reported function was influenced by prosthesis use, walking speed, and comorbidities.
Population
305 volunteers with lower limb loss (69% men, mean age 56 years; 52% vascular amputation causes, 42% above-knee surgical levels, 82% with comorbidities).
Effective Dosage
Not available
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
balance ability | neutral | 2-Minute Walk Test (2MWT) | volunteers with lower limb loss | - | explained the variance | #1 |
Activities-specific Balance Confidence (ABC) | neutral | 2-Minute Walk Test (2MWT) | volunteers with lower limb loss | - | explained the variance | #2 |
Houghton score | neutral | 2-Minute Walk Test (2MWT) | volunteers with lower limb loss | - | explained the variance | #3 |
sex | neutral | 2-Minute Walk Test (2MWT) | volunteers with lower limb loss | - | explained the variance | #4 |
amputation cause | neutral | 2-Minute Walk Test (2MWT) | volunteers with lower limb loss | - | explained the variance | #5 |
surgical level | neutral | 2-Minute Walk Test (2MWT) | volunteers with lower limb loss | - | explained the variance | #6 |
balance ability | neutral | performance-based walking | people with limb loss | - | explained | #7 |
confidence | neutral | performance-based walking | people with limb loss | - | explained | #8 |
prosthesis use | neutral | performance-based walking | people with limb loss | - | explained | #9 |
walking aid use | neutral | performance-based walking | people with limb loss | - | explained | #10 |
prosthesis use | neutral | patient-reported function | people with limb loss | - | explained | #11 |
walking aid use | neutral | patient-reported function | people with limb loss | - | explained | #12 |
walking speed | neutral | patient-reported function | people with limb loss | - | explained | #13 |
medical comorbidities | neutral | patient-reported function | people with limb loss | - | explained | #14 |
OBJECTIVES: Various modifiable and non-modifiable factors affect functional mobility, but subjective patient-reported and objective performance-based measures are rarely combined in explanatory analyses of functional mobility in people with limb loss. This study determined separate explanatory models for patient-reported function using the Prosthetic Evaluation Questionnaire Mobility Subscale (PEQ-MS), and performance-based 2-Minute Walk Test (2MWT). DESIGN: Retrospective cross-sectional observational analysis. SETTING: Wellness-walking program. PARTICIPANTS: Three hundred five volunteers with lower limb loss participated. Sixty nine percent were men, mean age 56 (15) years. Fifty two percent had vascular amputation causes, 42% had surgical levels above the knee, and 82% had medical comorbidities. Walking levels included limited-household (21%), limited-community (30%), and independent-community (49%). Outcome measures included patient-reported PEQ-MS, Activities-specific Balance Confidence (ABC) and Houghton scales; and performance-based balance and walking. MAIN OUTCOMES: Separate PEQ-MS and 2MWT multiple regression models fit using backward deletion. RESULTS: Modifiable (balance ability, ABC, Houghton score; P<0.05) and non-modifiable factors (sex, amputation cause, surgical level; P<0.05) explained the variance in 2MWT (adjusted R CONCLUSIONS: Both modifiable and non-modifiable factors explained prosthetic functional mobility. Performance-based walking was explained by modifiable factors including balance ability and confidence, prosthesis and walking aid use. Patient-reported function was also explained by prosthesis and walking aid use, walking speed and medical comorbidities. Modifiable factors for objective and subjective prosthetic mobility may provide a clinical roadmap for rehabilitation.