title: Physical Activity in Adults with Diabetes Following Prosthetic Rehabilitation.
abstract: OBJECTIVE
  To determine whether adults with diabetes and with transtibial amputations (TTAs) are meeting the recommended guidelines for physical activity intensity and daily step counts. The secondary objectives were to 1) to explore whether physical activity levels are maintained following discharge from prosthetic rehabilitation and 2) to determine whether clinical measures of physical function are associated with physical activity.
  
  
  METHODS
  Adults ≥40 years of age with TTAs secondary to diabetes were recruited following discharge from prosthetic rehabilitation. Outcomes included accelerometer-measured physical activity (worn on the ankle of the intact limb), the 2-minute walk test, gait speed, the L-test and balance confidence. Assessments were conducted at 3 months (baseline) and at 9 months following discharge from rehabilitation. Analyses included paired sample t tests and Pearson correlation coefficients.
  
  
  RESULTS
  The mean age for all participants (n=22) was 63±12 years. Participants took 3809±2189 steps per day at follow up, markedly lower than the 6500 steps per day recommended for older adults with chronic illness. Participants accumulated 24±41 minutes per week of moderate to vigorous physical activity, falling well below the recommended total of 150 minutes per week. An improvement was observed for performance on the L-test of functional mobility at follow up (-8.7 s±11.4; p=0.008). All other outcomes remained stable over time. Physical activity exhibited a good to excellent correlation with the 2-minute walk test distance (r=0.753; p<0.001) and gait speed (r=0.752; p<0.001) at discharge from rehabilitation.
  
  
  CONCLUSIONS
  Physical activity levels for adults with diabetes and TTAs remain stable following discharge from prosthetic rehabilitation but fall well below recommended guidelines of 6500 steps per day and 150 minutes of moderate to vigorous physical activity per week.
authors.affiliation: Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Respiratory Medicine, West Park Healthcare Centre, York, Ontario, Canada.
authors.forename: Laura
authors.initials: L
authors.lastname: Desveaux
authors.affiliation: Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Respiratory Medicine, West Park Healthcare Centre, York, Ontario, Canada; Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Roger S
authors.initials: RS
authors.lastname: Goldstein
authors.affiliation: Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Respiratory Medicine, West Park Healthcare Centre, York, Ontario, Canada; Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Sunita
authors.initials: S
authors.lastname: Mathur
authors.affiliation: Department of Respiratory Medicine, West Park Healthcare Centre, York, Ontario, Canada.
authors.forename: Ali
authors.initials: A
authors.lastname: Hassan
authors.affiliation: Department of Physiatry, West Park Healthcare Centre, York, Ontario, Canada.
authors.forename: Michael
authors.initials: M
authors.lastname: Devlin
authors.affiliation: Nathan Clinical Research Institute, West Park Healthcare Centre, York, Ontario, Canada.
authors.forename: Tim
authors.initials: T
authors.lastname: Pauley
authors.affiliation: Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Respiratory Medicine, West Park Healthcare Centre, York, Ontario, Canada; Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. Electronic address: dina.brooks@utoronto.ca.
authors.forename: Dina
authors.initials: D
authors.lastname: Brooks
mesh_terms: D000368:Aged; D000671:Amputation, Surgical / Q000534:rehabilitation*; D048909:Diabetes Complications / Q000534:rehabilitation*; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019736:Prostheses and Implants; D016138:Walking
keywords: activité physique; chronic diabetic complications; complications du diabète de longue durée; disease management; fonctionnement physique; physical activity; physical function; prise en charge de la maladie; rehabilitation; réadaptation