Residual and sound limb hip strength distinguish between sedentary and nonsedentary adults with transtibial amputation.
Mayank Seth, Ryan T Pohlig, Emma H Beisheim-Ryan and 4 others
PMID 35131977WHAT IT FOUND
Hip strength measured with a handheld dynamometer can identify which adults with lower-leg amputation are likely to be sedentary.
Weak residual-limb hip extension or sound-limb hip adduction strongly suggests a patient is walking less than 5,000 steps per day.
Key findings
01Residual limb hip extensor strength below a normalized cut-point of 0.20 identifies patients at risk of sedentarism, while strength at or above this level effectively rules it out.
02Sound limb hip adductor strength below a normalized cut-point of 0.16 is the strongest single indicator for ruling in sedentarism, raising the probability of being sedentary from 30% to 69%.
03A composite score summing risk across six hip strength measures is associated with physical activity status, where each one-point increase in the score corresponds to a 2.2-fold increase in the odds of being sedentary.
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 size was small (n=44), which limits the reliability of the cut-points and prevents the creation of normative data based on factors like time since amputation. The study only included adults with unilateral transtibial amputation who had been amputated for at least one year, so findings do not apply to recent amputees, those with bilateral amputations, or children. Physical activity was dichotomized at 5,000 steps/day, so the cut-points may not accurately identify risk at other activity thresholds. Limb length was not considered when normalizing strength, which may affect comparisons between the residual and sound limbs.
Declared interests
The paper does not explicitly state conflicts of interest or funding sources in the provided text, but notes the data was part of a larger study approved by the University of Delaware IRB.
The easy way to misread this
Do not assume these hip strength cut-points are diagnostic for all amputees. The study was small, cross-sectional, and only applied to adults with unilateral transtibial amputation who had been amputated for over a year. The cut-points are preliminary screening tools, not definitive measures of overall health or function.