Risk Factors for Falls in Individuals With Lower Extremity Amputations During the Pre‐Prosthetic Phase: A Retrospective Cohort Study

• Published in: PM & R 2019-08, Vol.11 (8), p.828-833
• Main Authors: Vu, Kimberly, Payne, Michael W.C., Hunter, Susan W., Viana, Ricardo
• Format: Article
• Language: English
• ISSN: 1934-1482; 1934-1563
• DOI: 10.1002/pmrj.12046

Background Falls in individuals with lower limb amputations (LLAs) pose significant health concerns. The literature is limited regarding falls during the preprosthetic phase of rehabilitation for persons with LLAs. Objective To determine the incidence of falls and identify factors associated with falls during the preprosthetic recovery phase. Design Retrospective chart audit. Setting Inpatient rehabilitation program. Participants Four hundred forty individuals with LLAs (age ± SD = 61.93 ± 14.53 years, 73.18% male) who attended inpatient rehabilitation from 26 July 2011 to 21 August 2017. Interventions Not applicable. Main Outcome Measurements The number of self‐reported falls was recorded from the time of surgery to admission for inpatient rehabilitation. Outcomes of interest were any fall (1+ fall) and recurrent falls (2+ falls). A retrospective chart audit was performed on consecutive admissions to an inpatient rehabilitation program. Results The incidence of falls was 8.37 per 1000 patient‐days. Falls were sustained by 60.9% of the sample. Unilateral transtibial amputation was independently associated with an increased risk of recurrent falls (relative risk [RR] 1.59, 95% confidence interval [CI] 1.13–2.23, P = .008). Diabetes mellitus was independently associated with an increased risk of any fall (RR 1.18, 95% CI 1.01–.38, P = .03). Finally, bilateral transtibial amputation was independently associated with a reduced risk of any fall (RR 0.59, 95% CI 0.39–0.90, P = .014). Conclusions Consistent with the current literature, diabetes mellitus and a unilateral transtibial amputation were risk factors for falling, whereas a bilateral transtibial amputation and increasing age presented new findings as factors associated with decreased falling. Level of Evidence III.