Validating a fear-of-falling-related activity avoidance scale in lower limb prosthesis users.
Noah J Rosenblatt, Matthew J Major, Bobak Manesh and 2 others
PMID 37632836WHAT IT FOUND
The mSAFE appeared usable to measure how much lower-limb prosthesis users avoid activities because of fear of falling.
A 6-item version may also work. The evidence comes from 59 people who could walk in the community.
Key findings
01The 17-item mSAFE behaved as expected: scores moved with related measures and were higher in people with falls, assistive device use, fear of falling, or fear-related activity avoidance.
02Most participants reported fear-related activity avoidance (69.5%) and three or more falls (55.9%).
03A six-item version showed similar validity patterns, but the item-reduction checks were mixed.
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 analysis included 59 participants, and the sample size was chosen because of time and resources, not a planned power calculation. The cohort was overwhelmingly white, with only 6.5% identifying as Black or African American, and 67% had unilateral transtibial amputation. Only 10% reported diabetes complications as the amputation cause, so the sample may not represent people with dysvascular amputation. The study only included people who could walk in the community, so it says little about prosthesis users who use the prosthesis mainly for transfers. The fear-of-falling question asked about fear of falling and hurting yourself, not fear of lost independence or embarrassment. The fall definition excluded fainting, which may not match some current definitions of falls. The 6-item version was selected using the same data, without asking prosthesis users whether the items were relevant.
Declared interests
The supplied article metadata lists NIH extramural research support. No author conflict-of-interest declaration is provided in the supplied text.
The easy way to misread this
Do not treat the mSAFE as validated for all lower-limb prosthesis users. The study included 59 mostly white, unilateral transtibial, community-ambulating participants, and the 6-item version was chosen from the same data.