A study published September 4 in the American Journal of Physical Medicine & Rehabilitation determined that while people with vascular-related amputations were less likely to fall than those with nonvascular-related amputations, people with concurrent vascular comorbidities were more likely to fall than those without.
As part of the study, researchers investigated the impact of balance ability, Activities-specific Balance Confidence (ABC), and other self-reported and clinical factors on the incidence of falls among people with lower-limb loss.
Of the 305 participants in the cross-sectional study, 68.3 percent were men aged 55.5 years (± 14.9 years), with 50 percent dysvascular amputations and 56.8 percent transtibial amputations. The average ABC score was 2.1/4 (± 1.1), balance ability equaled 2.9/4 (± 1.3), and walking speed totaled 0.766 m/s (± 0.387).
The final model showed fall risk was heightened for people with vascular comorbidities (odds ratio [OR]= 3.46, 95 percent confidence interval [CI]= 1.40-8.54) and better balance (OR = 23.29, CI = 3.19-170.23). The rates were attenuated for people with transfemoral (OR = 0.08, CI = 0.01-0.82) and vascular amputations (OR = 0.38, CI = 0.15-0.95). Significant interactions existed between age and amputation level (OR = 1.06, CI = 1.02-1.11) and between balance confidence and balance ability (OR = 0.27, CI = 0.13-0.57).
The study concluded that while individuals with transfemoral amputations were less likely to fall, the risk of falling increased with each year of age compared to people with transtibial amputations. People with balance ability scores equal to or greater than 3.5 fell more often than those with lower ability, but people with lower balance ability and mismatched confidence in their balance ability had 3.7 times greater fall risk, the study found.