PTCohortDisability and rehabilitation2024

Daily steps and stepping cadence increase one-year following prosthesis osseointegration in people with lower-limb amputation.

Brecca M M Gaffney, Hope C Davis-Wilson, Mohamed E Awad and 5 others

PMID 37073780

WHAT IT FOUND

Twelve months after osseointegration, people with lower-limb amputation took more daily steps, walked in longer bouts, and had higher step cadence.

They also received rehabilitation, so the increase cannot be credited to osseointegration alone.

Key findings

01Average daily step count and stepping time increased 12 months after prosthesis osseointegration.

02Average duration of stepping bouts increased 12 months after prosthesis osseointegration.

03Average and maximum step cadence per bout increased after prosthesis osseointegration.

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

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What it does not show

The study had no control group, so changes after surgery could be related to time, rehabilitation, or selection of participants rather than osseointegration alone. Only 14 patients were included, and their baseline walking activity was not controlled, so the results may not apply to all people with lower-limb amputation. Higher functioning patients at baseline showed less improvement. This may reflect a ceiling effect. The activity monitor may not give identical step counts to other monitors, although it has been shown to measure steps accurately in adults with lower-limb amputation. After the 3-week clinic protocol, rehabilitation was personalized in home-based clinics, so differences in later rehabilitation may have affected outcomes.

Declared interests

The authors reported no financial or material support for the research, authorship, or publication.

The easy way to misread this

Do not conclude that osseointegration alone caused the increase in walking activity. Every participant also received a 3-week rehabilitation protocol and then personalized home-based rehabilitation, and there was no control group, so the contribution of surgery, rehabilitation, and time cannot be separated.

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