Physical Function and Pre-Amputation Characteristics Explain Daily Step Count after Dysvascular Amputation.
Matthew J Miller, Paul F Cook, Paul W Kline and 3 others
PMID 30729727WHAT IT FOUND
Four factors explain 62% of daily step count after dysvascular amputation: walking distance in a 2-minute test, assistive device use, cardiovascular disease, and pre-amputation walking time.
Rehabilitation should target these alongside physical function.
Key findings
01A final model including 2-minute walk test distance, assistive device use, cardiovascular disease presence, and pre-amputation walking time explained 62% of the variability in daily step count.
02Greater 2-minute walk distance, non-use of an assistive device, absence of cardiovascular disease, and more pre-amputation walking time were associated with higher daily step counts.
03Participants averaged 1450 steps per day, which falls into the most sedentary category and is less than one-third of recommended levels for older adults or people with disabilities.
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 study is cross-sectional, so it cannot prove that these factors cause changes in step count, only that they are associated. The sample was small (n=57 analyzed) and largely comprised men with unilateral transtibial amputation within 5 years of surgery, limiting generalizability to women, bilateral amputees, or those with transfemoral amputations. Pre-amputation walking time was self-reported, which introduces potential recall bias. The study could not detect variables with smaller effect sizes due to the limited sample size.
Declared interests
The research was supported by the National Institutes of Health (N.I.H.) and non-U.S. government sources. No commercial conflicts of interest were declared in the provided text.
The easy way to misread this
Do not interpret the 62% variability explained as proof that changing these factors will increase step count. The study is cross-sectional and cannot establish causality, and the sample was small and homogeneous (mostly men with transtibial amputations), so results may not apply to all patients.