@article{ref1,
title="Impact of vascular disease, amputation level, and the mismatch between balance ability and balance confidence in a cross sectional study of the likelihood of falls among people with limb loss: perception versus reality",
journal="American journal of physical medicine and rehabilitation",
year="2019",
author="Wong, Christopher Kevin and Chihuri, Stanford T.",
volume="98",
number="2",
pages="130-135",
abstract="OBJECTIVE: Investigate impact of balance ability, Activities-specific Balance Confidence (ABC), and other self-reported and clinical factors on incidence of falls among people with lower-limb loss. <br><br>DESIGN: Cross-sectional study (N=305) with multivariable logistic regression analysis RESULTS: Participants included 68.3% males with age 55.5±14.9; with 50% dysvascular and 56.8% transtibial amputations. Average ABC=2.1/4 ±1.1, balance ability=2.9/4 ±1.3 and walking speed=0.766±0.387 m/s. The final model showed fall risk was heightened for people with vascular comorbidities (odds ratio [OR]=3.46, 95% confidence interval [CI]=1.40-8.54) and better balance (OR=23.29, CI=3.19-170.23); but 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). <br><br>CONCLUSIONS: While people with vascular amputations were less likely to fall than those with nonvascular amputations, people with concurrent vascular comorbidities were more likely to fall than those without. People with transfemoral amputations were less likely to fall-however, fall risk increased with each year of age compared to people with transtibial amputations. People with balance ability ≥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.<p /> <p>Language: en</p>",
language="en",
issn="0894-9115",
doi="10.1097/PHM.0000000000001034",
url="http://dx.doi.org/10.1097/PHM.0000000000001034"
}