"I was angry that I fell" all the way to "if I fall, I fall": a qualitative study of the spectrum of behavioral fall risk factors for veterans with dysvascular lower-limb amputation.
Laura A Swink, Rachael B Akay, Tonya L Rich and 4 others
PMID 39819166WHAT IT FOUND
Veterans with leg amputations described fall risks as a spectrum of behaviors.
Key factors included trust in the prosthesis, awareness of dual-tasking, and emotional regulation. Low trust led to device abandonment, while high trust encouraged risky activities. Self-imposed activity restriction after a fall was identified as a maladaptive behavior that increases future risk.
Key findings
01Participants reported varying levels of trust in their prosthesis, which influenced whether they wore it or engaged in risky activities.
02Many participants did not recognize they were dual-tasking during a fall, or denied it despite describing divided attention.
03Restricting participation in daily activities after a fall was identified as a maladaptive response that increases the risk of future falls.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The sample was small (21 participants) and all were male Veterans, limiting generalizability to women or non-Veteran populations. Data relied on retrospective recall of falls, which can be inaccurate due to memory bias. Self-efficacy and prosthesis trust were assessed qualitatively rather than with standardized measures. The study identifies associations and themes but cannot prove that these behavioral factors directly caused the falls.
Declared interests
No potential conflict of interest was reported. Some authors are employed by the Veterans Administration.
The easy way to misread this
Do not interpret high trust in the prosthesis or high self-efficacy as protective factors. The study found that Veterans with high trust and confidence often engaged in high-risk activities and reported numerous falls, suggesting that overconfidence can be a behavioral risk factor.