Using theoretical frameworks to examine fall history and associated prosthetic mobility in people with nondysvascular lower limb amputation

Sheila Clemens, Ignacio Gaunaurd, Michele Raya, Neva Kirk-Sanchez, Glenn Klute, Robert Gailey

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Background:Over a million people live with lower limb amputation (LLA) in the United States, and many of them will experience a fall in the next year. The aim of this study was to use existing theoretical frameworks in an attempt to organize the complex interactions of reported fall history and prosthetic mobility in community-ambulating people with LLA.Methods:Self-reported fall rate and fall circumstances were recorded in a cross-section of people with unilateral LLA due to nondysvascular causes. Self-report and performance-based standardized outcome measures assessed prosthetic mobility and balance confidence. All variables were considered and appropriately placed within a proposed International Classification of Functioning, Disability, and Health framework while using a fall-type classification framework to classify fall circumstances.Results:Information from 69 participants was analyzed. The reported fall rate was at 46%, with those with transfemoral amputation reporting significantly more falls than those with transtibial amputation (P = 0.001). Tripping over an object was the most common cause (62.5%), and fallers reported significantly lower perceived prosthetic mobility than nonfallers (P = 0.001). Despite reporting high levels of balance confidence, results indicate that all groups of fallers and nonfallers are at increased fall risk according to performance-based prosthetic mobility score cutoffs.Conclusions:Community-dwelling people with nondysvascular LLA are at increased fall risk. Classifying fall-related variables using theoretical frameworks provides a means to structure more informative fall risk surveys for people with LLA in an attempt to identify those at greater risk for falling and its potential detrimental effects.

Original languageEnglish
Pages (from-to)484-490
Number of pages7
JournalProsthetics and Orthotics International
Issue number5
StatePublished - Oct 1 2022

Bibliographical note

Funding Information:
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the United States Department of Defense (DOD)-Veterans Affairs (VA) Joint Incentive Fund (JIF) Project Titled “Mobile Device Outcomes Based Rehabilitation Program”; and a grant from the American Orthotic and Prosthetic Association (AOPA) project titled, “Utilizing an innovative Timed-Up-and-Go test for fall risk detection in people with unilateral lower limb loss.” Effort in writing the research reported in this publication was supported by the National Institute on Minority Health and Health Disparities of the National Institutes of Health under Award No. U54MD012393, Florida International University Research Center in Minority Institutions. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Publisher Copyright:
© 2022 SAGE Publications Inc.. All rights reserved.


  • falls
  • lower limb amputation
  • theoretical frameworks

ASJC Scopus subject areas

  • Medicine (all)


Dive into the research topics of 'Using theoretical frameworks to examine fall history and associated prosthetic mobility in people with nondysvascular lower limb amputation'. Together they form a unique fingerprint.

Cite this