title: The prevalence and risk factors of falling and fear of falling among lower extremity amputees.
abstract: OBJECTIVE
  To estimate the falling experience and fear of falling status and to describe characteristics associated with falling and fear of falling.
  
  
  METHODS
  Population-based consecutive sample survey and chart review.
  
  
  METHODS
  Two Canadian, regional, university-affiliated outpatient amputee clinics.
  
  
  METHODS
  The sample (n = 435; mean age, 62 +/- 15.7 yr) of community-living participants was mostly male (71%), had unilateral (below knee 73%; above knee 27%) amputations primarily for vascular (53% vs 47% nonvascular) reasons.
  
  
  METHODS
  Review patient charts and survey questionnaires to determine sociodemographic information (eg, social support), information about the amputation (eg, cause, level, problems), physical health and function (eg, pain, limitations, comorbidity), and psychologic state (depression, adaptation).
  
  
  METHODS
  Occurrence of a fall in the past 12 months and presence of a fear of falling.
  
  
  RESULTS
  Exactly 52.4% subjects reported falling in the past year, whereas 49.2% reported a fear of falling. Logistic regression analyses revealed falling was related to having an above knee amputation (odds ratio [OR] = 2.78; 95% confidence interval [CI] = 1.71-4.51), back (OR = 1.96; 95% CI = 1.08-3.54) and joint (OR = 1.67; 95% CI = 1.01-2.74) pain, and multiple stump and prosthesis problems (OR = 3.09; 95% CI = 1.58-6.04). Having had the amputation > or = 4 years in the past was protective (OR =.53; 95% CI =.29-.89). Factors related to an increase risk of fear of falling included having to concentrate on each step while walking (OR = 4.06; 95% CI = 2.46-6.71) and having a fall in the past 12 months (OR = 1.62; 95% CI = 1.04-2.54), whereas being male (OR = 0.35; 95% CI =.21-.57) and having good to excellent perceived health (OR =.35; 95% CI =.21-.58) were protective.
  
  
  CONCLUSIONS
  Falling and fear of falling are pervasive among amputees. Comprehensive and ongoing intervention and education should be considered. Research is required to assess the consequences of falling and fear of falling.
authors.affiliation: Faculty of Medicine, School of Rehabilitation Sciences, University of British Columbia, Vancouver, BC, Canada. bcmiller@telus.net
authors.forename: W C
authors.initials: WC
authors.lastname: Miller
authors.forename: M
authors.initials: M
authors.lastname: Speechley
authors.forename: B
authors.initials: B
authors.lastname: Deathe
mesh_terms: D000058:Accidental Falls; D000328:Adult; D000368:Aged; D000674:Amputees / Q000523:psychology* / Q000534:rehabilitation; D002170:Canada / Q000453:epidemiology; D005239:Fear / Q000523:psychology*; D005260:Female; D006304:Health Status; D006801:Humans; D007866:Leg; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012944:Social Support; D011795:Surveys and Questionnaires