title: Balance confidence and activity of community-dwelling patients with transtibial amputation.
abstract: The purpose of this study was to examine the relationship between balance confidence and community-based physical activity. Twenty-two community-dwelling patients with right or left unilateral transtibial amputation who reported no falls in the past 6 mo completed the Activities-Specific Balance Confidence Scale (ABC) and wore a StepWatch Activity Monitor for 7 consecutive d in the community. Subjects were subsequently stratified as low ( <3,000 steps/d) or high (>/=3,000) steps/d) activity groups. Balance confidence was significantly lower among the low activity weekday group (LAG, 70.8 +/- 12.0 versus 88.9 +/- 8.7, t(20) = 3.97, p = 0.001). Further, correlation analysis revealed a positive correlation between ABC score and step total (r = 0.55, p < 0.01). It is unknown whether the LAG limited ambulation as an intentional strategy of fall-risk avoidance. Although clinicians routinely inquire about falls in the community among patients with lower-limb amputation, the results of this study emphasize the importance of contextualizing recent fall history relative to activity level. Clinicians can use this contextual information when considering the inclusion of appropriate fall-risk mediation strategies relative to activity levels and counseling patients of the benefits of physical exercise for maintaining functional capacity and general health.
authors.forename: Alena
authors.initials: A
authors.lastname: Mandel
authors.affiliation: Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada.
authors.forename: Kailan
authors.initials: K
authors.lastname: Paul
authors.affiliation: Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada.
authors.affiliation: Nathan Clinical Research Institute, West Park Healthcare Centre, Toronto, ON, Canada.
authors.forename: Ruby
authors.initials: R
authors.lastname: Paner
authors.affiliation: Amputee Rehabilitation Services, West Park Healthcare Centre, Toronto, ON, Canada.
authors.forename: Michael
authors.initials: M
authors.lastname: Devlin
authors.affiliation: Amputee Rehabilitation Services, West Park Healthcare Centre, Toronto, ON, Canada.|Division of Physiatry, Department of Medicine, University of Toronto, ON, Canada.
authors.forename: Steve
authors.initials: S
authors.lastname: Dilkas
authors.affiliation: Nathan Clinical Research Institute, West Park Healthcare Centre, Toronto, ON, Canada.
authors.forename: Tim
authors.initials: T
authors.lastname: Pauley
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control; D056044:Actigraphy; D000368:Aged; D000674:Amputees / Q000523:psychology*; D001186:Artificial Limbs; D005260:Female; D006801:Humans; D057187:Independent Living; D007866:Leg; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D004856:Postural Balance; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D013977:Tibia; D016138:Walking / Q000523:psychology*
keywords: ambulation; amputation; amputees; artificial limbs; balance confidence; community; fall risk; lower extremity; mobility capacity; physical activity; prosthesis; transtibial