Falls after Dysvascular Transtibial Amputation: A Secondary Analysis of Falling Characteristics and Reduced Physical Performance.

INTRODUCTION: Over half of all people with lower limb amputation (LLA) experience at least one fall annually. Furthermore, the majority of LLAs result from dysvascular health complications, contributing to balance deficits. However, fall-related research specific to dysvascular LLA remains limited. OBJECTIVE: To 1) characterize falls among adults with dysvascular LLA, using an existing Fall-Type Classification Framework and 2) to describe functional characteristics of participants across the framework categories. DESIGN: Secondary data analysis from two randomized controlled trials. SETTING: Outpatient setting. PARTICIPANTS: People (n = 69) six months to five years from dysvascular lower extremity amputation, who were >/= 50 yr of age and independently ambulatory using a prosthesis. INTERVENTION: None. OUTCOME: Descriptions of self-reported falls were collected on a weekly basis for 12 wk, and analyzed using an existing Fall-Type Classification Framework. Fall frequencies, estimated count, and estimated proportions were compared across all framework categories, with 95% confidence intervals. Functional measures (Timed Up and Go, Two Minute Walk, Five Meter Walk, and average step count) were collected, and averages for each participant who experienced a fall were calculated. RESULTS: 30 participants (43.5%) reported 42 falls within 12 wk. A variety of fall types were described. Incidence of falls were highest for intrinsic destabilization sources, from incorrect weight shift patterns, during transfer activities. CONCLUSION: Patients with dysvascular LLA experience a variety of fall types. The high frequency of intrinsically sourced, incorrect weight shift falls during transfer activities emphasize the need to focus rehabilitation efforts on improving postural control in patients with dysvascular LLA during activities such as reaching, turning, and transferring. This article is protected by copyright. All rights reserved.