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Balance Confidence Among People With Lower-Limb Amputations

WC Miller, PhD, MSC(OT), is Assistant Professor, Faculty of Medicine, School of Rehabilitation Sciences, University of British Columbia, T325 Third Floor, Koerner Pavilion, 2211 Wesbrook Mall, Vancouver, British Columbia, Canada V6T 2B5 (bcmiller{at}telus.net). Address all correspondence to Dr Miller
M Speechley, PhD, is Associate Professor, Faculty of Medicine and Dentistry, Department of Epidemiology and Biostatistics, University of Western Ontario, London, Ontario, Canada
AB Deathe, MD (FRCPC), is Associate Professor, Department of Physical Medicine and Rehabilitation, University of Western Ontario, and Medical Director, Amputee Program, St Joseph's Health Care London, London, Ontario, Canada

Background and Purpose. Confidence in a person's balance has been shown to be an important predictor of social activity among people with lower-limb amputations. The purposes of this study were to describe confidence in balance among people with transtibial or transfemoral lower-limb amputations and to compare people whose amputations were due to vascular and nonvascular causes. Subjects and Methods. A survey of a sample of 435 community-dwelling individuals from 2 regional clinics was conducted. The sample consisted of people with unilateral transfemoral (26.7%) and transtibial (73.3%) amputations who lost their limb for vascular (53%) and nonvascular (47%) reasons. The mean age of the primarily male (71%) sample was 62.0 years (SD=15.7). Results. Mean scores, using the Activities-specific Balance Confidence (ABC) Scale, were 63.8 for the total sample, 54.1 for the subjects with amputations due to vascular reasons, and 74.7 for the subjects with amputations due to nonvascular reasons. Given a maximum possible ABC Scale score of 100, the results suggest that confidence was low. A difference between the subjects with amputations due to vascular reasons and those with amputations due to nonvascular reasons was observed over each item of the ABC Scale. Variables that were statistically related to balance confidence included age, sex, etiology, mobility device use, the need to concentrate while walking, limitations in activities of daily living, depression, and fear of falling. Discussion and Conclusion. Balance confidence scores among the study sample were low when compared with values previously reported by other researchers. Confidence was particularly low among individuals who had their amputation for vascular reasons. Balance confidence might be an important area of clinical concern.

Key Words: Balance confidence • Fear of falling • Lower-limb amputation

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