Clinical mobility metrics estimate and characterize physical activity following lower-limb amputation

Mayank Seth; Ryan Todd Pohlig; Gregory Evan Hicks; Jaclyn Megan Sions

doi:10.1186/s13102-022-00518-x

Clinical mobility metrics estimate and characterize physical activity following lower-limb amputation

BMC Sports Sci Med Rehabil. 2022 Jul 7;14(1):124. doi: 10.1186/s13102-022-00518-x.

Authors

Mayank Seth¹, Ryan Todd Pohlig², Gregory Evan Hicks³, Jaclyn Megan Sions^{4

5}

Affiliations

¹ Delaware Limb Loss Studies, Department of Physical Therapy, University of Delaware, 540 South College Avenue, Suite 210JJ, Newark, DE, 19713, USA.
² Biostatistics Core, University of Delaware, Newark, DE, USA.
³ Delaware Spine Studies, Department of Physical Therapy, University of Delaware, Newark, DE, USA.
⁴ Delaware Limb Loss Studies, Department of Physical Therapy, University of Delaware, 540 South College Avenue, Suite 210JJ, Newark, DE, 19713, USA. megsions@udel.edu.
⁵ Delaware Spine Studies, Department of Physical Therapy, University of Delaware, Newark, DE, USA. megsions@udel.edu.

Abstract

Background: Regular physical activity following a lower-limb amputation is essential for maintaining health and a high quality of life. Most adults with a lower-limb amputation, however, participate in insufficient daily physical activity, and thus, are predisposed to poor health outcomes. Estimating physical activity after lower-limb amputation via common mobility metrics may aid in clinical decisions regarding treatment prioritization and prosthesis prescription. The objectives of this study were (a) to examine associations between daily physical activity and patient-reported and performance-based mobility metrics among adults with lower-limb amputation, and (b) to determine whether patient-reported and performance-based mobility metrics can distinguish between physical activity status [i.e., sedentary (< 5000 steps/day) or non-sedentary (≥ 5000 steps/day)] of adults with lower-limb amputation.

Methods: A cross-sectional study involving 35 adults with a unilateral transtibial (N = 23; 63.0 ± 10.4 years) or transfemoral amputation (N = 12; 58.8 ± 9.5 years) was conducted. Participants completed patient-reported (Prosthesis Evaluation Questionnaire-Mobility Subscale) and performance-based mobility metrics (L-Test, 10-m Walk Test, 6-min Walk Test). Physical activity, i.e., average steps/day, was measured with an accelerometer.

Results: Patient-reported and performance-based mobility metrics were associated with daily physical activity (p < 0.050). Prosthesis Evaluation Questionnaire-Mobility Subscale scores, L-Test time, 10-m Walk Test speed and 6-min Walk Test distance independently explained 11.3%, 31.8%, 37.6% and 30.7% of the total variance in physical activity. Receiver operating characteristic curves revealed patient-reported and performance-based mobility metrics significantly distinguish between physical activity status, i.e., sedentary (< 5000 steps/day) versus non-sedentary (≥ 5000 steps/day). Preliminary cut-points for mobility metrics to classify physical activity status were determined.

Conclusions: Following a lower-limb amputation, patient-reported and performance-based mobility metrics may estimate daily physical activity, thereby aiding clinical decisions regarding treatment prioritization as well as prosthesis selection.

Keywords: Fitness trackers; Outcome measures; Physical inactivity; Prosthesis; Rehabilitation; Walk test; Walking speed.

Abstract

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