title: Factors related to high-level mobility in male servicemembers with traumatic lower-limb loss.
abstract: The purpose of this study was to examine the possible relationship between factors modifiable by rehabilitation interventions (rehabilitation factors), other factors related to lower-limb loss (other factors), and high-level mobility as measured by the Comprehensive High-Level Activity Mobility Predictor (CHAMP) in servicemembers (SMs) with traumatic lower-limb loss. One-hundred eighteen male SMs with either unilateral transtibial amputation (TTA), unilateral transfemoral amputation (TFA), or bilateral lower-limb amputation (BLLA) participated. Stepwise regression analysis was used to develop separate regression models of factors predicting CHAMP score. Regression models containing both rehabilitation factors and other factors explained 81% (TTA), 36% (TFA), and 91% (BLLA) of the variance in CHAMP score. Rehabilitation factors such as lower-limb strength and dynamic balance were found to be significantly related to CHAMP score and can be enhanced with the appropriate intervention. Further, the findings support the importance of salvaging the knee joint and its effect on high-level mobility capabilities. Lastly, the J-shaped energy storage and return feet were found to improve high-level mobility for SMs with TTA. These results could help guide rehabilitation and aid in developing appropriate interventions to assist in maximizing high-level mobility capabilities for SMs with traumatic lower-limb loss.
authors.affiliation: Miami Department of Veterans Affairs Healthcare System, 1201 NW 16th St, Miami, FL 33125. ignacio.gaunaurd@va.gov.
authors.forename: Ignacio A
authors.initials: IA
authors.lastname: Gaunaurd
authors.forename: Kathryn E
authors.initials: KE
authors.lastname: Roach
authors.forename: Michele A
authors.initials: MA
authors.lastname: Raya
authors.forename: Rebecca
authors.initials: R
authors.lastname: Hooper
authors.forename: Alison A
authors.initials: AA
authors.lastname: Linberg
authors.forename: Justin Z
authors.initials: JZ
authors.lastname: Laferrier
authors.forename: Stuart M
authors.initials: SM
authors.lastname: Campbell
authors.forename: Charles
authors.initials: C
authors.lastname: Scoville
authors.forename: Robert S
authors.initials: RS
authors.lastname: Gailey
mesh_terms: D015998:Abbreviated Injury Scale; D000328:Adult; D000367:Age Factors; D000672:Amputation Stumps / Q000033:anatomy & histology; D000673:Amputation, Traumatic / Q000503:physiopathology* / Q000534:rehabilitation*; D001186:Artificial Limbs; D001835:Body Weight; D003430:Cross-Sectional Studies; D005080:Exercise Test; D005269:Femur / Q000293:injuries; D005684:Gait / Q000502:physiology; D006801:Humans; D035002:Lower Extremity / Q000293:injuries / Q000503:physiopathology; D008297:Male; D008889:Military Personnel; D051346:Mobility Limitation; D053580:Muscle Strength / Q000502:physiology; D018482:Muscle, Skeletal / Q000293:injuries / Q000503:physiopathology; D004856:Postural Balance / Q000502:physiology; D011474:Prosthesis Design; D013977:Tibia / Q000293:injuries; D013997:Time Factors; D014481:United States; D055105:Waist Circumference; D016138:Walking / Q000502:physiology*; D055815:Young Adult
keywords: CHAMP; gait; high-level mobility; injury severity; lower-limb loss; prosthetics; rehabilitation; servicemembers; traumatic amputation; waist circumference