Time Since Lower-Limb Amputation: An Important Consideration in Mobility Outcomes.
Mayank Seth, Emma Haldane Beisheim, Ryan Todd Pohlig and 3 others
PMID 34915544WHAT IT FOUND
More years since a leg amputation were associated with better self-reported mobility and timed chair-to-walk performance in 109 prosthesis users.
Walking speed and endurance improved until about 20 years, then plateaued or declined.
Key findings
01Time since amputation was significantly associated with all four mobility outcomes in the 109 included adults, with correlation coefficients of 0.33 for self-reported mobility, -0.23 for Timed Up and Go, 0.30 for 10-Meter Walk Test, and 0.37 for 6-Minute Walk Test.
02Each additional year since amputation was associated with a 0.22-point increase in self-reported mobility scores, where higher scores mean greater perceived mobility.
03For fast walking speed, each additional year since amputation was associated with a 0.02 m/sec increase for participants under 20 years and for participants 20 to 40 years post-amputation, and a 0.02 m/sec decrease for participants over 40 years.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
This was a cross-sectional study, so it cannot show that time since amputation caused mobility changes. Results apply only to community-dwelling adults at least 1 year after unilateral transfemoral or transtibial amputation who used a prosthesis. The sample excluded people with contralateral limb amputation, neurological conditions that limited walking, and people not using a prosthesis. People with more than 40 years since amputation were under-represented, so estimates for later time points are less secure. Some amputation causes were combined because of small numbers, and the study did not capture actual prosthesis experience such as weekly wear. A considerable amount of mobility variance was not explained, and psychological or social factors were not measured. The study did not include minors, people acutely post-amputation, home-level ambulators, or people with a significant comorbidity burden.
Declared interests
The supplied article types include NIH extramural and non-U.S. government research support. The text provided does not include an author conflict-of-interest declaration.
The easy way to misread this
Do not read time since amputation as a cause of better or worse mobility. The study compared different people at a single time point, so it cannot show that the passage of time changed their mobility.