Physical Function and Pre-Amputation Characteristics Explain Daily Step Count after Dysvascular Amputation.

ABSTRACT:

Background

People with dysvascular lower limb amputation (LLA) achieve one-third of the recommended steps per day and experience severe disability. Although physical function improves with rehabilitation after dysvascular LLA, physical activity remains largely unchanged, and factors contributing to limited daily step count are unknown.

Objectives

To identify factors that contribute to daily step count after dysvascular LLA.

Design

Cross-sectional, secondary data analysis.

Setting

Outpatient rehabilitation facilities.

Participants

Fifty-eight patients with dysvascular major LLA (age: 64 ± 9 years, body mass index: 30 ± 8 kg/m² , male: 95%, transtibial LLA: 95%).

Methods

Data were collected by a blinded assessor after dysvascular LLA. Candidate explanatory variables included (1) demographics, (2) LLA characteristics, (3) comorbidities and health behaviors, and (4) physical function. Variables with univariate associations with log steps/day (transformed due to non-normality) were included in a multiple linear regression model using backward elimination to identify factors that explained significant variability in log steps/day.

Primary outcome measure

The primary outcome, daily step count, was measured with accelerometer-based activity monitors worn by participants for 10 days.

Results

Participants took an average (± SD) of 1450 ± 1309 steps/day. After backward elimination, the final model included four variables explaining 62% of the overall daily step count (P < .0001): 2-minute walk distance (32%), assistive device use (11%), cardiovascular disease (10%), and pre-amputation walking time (11%).

Conclusions

Average daily step count of 1450 steps/day reflects the lowest category of sedentary behavior. Physical function, cardiovascular disease, and pre-amputation walking time explain 62% of daily step count after dysvascular LLA. Although physical rehabilitation commonly focuses on improving physical function, interventions to increase daily step count after dysvascular LLA should also consider chronic disease and health behaviors that predate LLA.

Level of evidence

III.

SUBMITTER: Miller MJ 

PROVIDER: S-EPMC8259321 | biostudies-literature |

REPOSITORIES: biostudies-literature