Physical Function and Pre-Amputation Characteristics Explain Daily Step Count after Dysvascular Amputation.
Accelerometry
/ instrumentation
Amputation, Surgical
Cardiovascular Diseases
/ complications
Cross-Sectional Studies
Dependent Ambulation
Diabetic Angiopathies
/ surgery
Female
Health Behavior
Humans
Lower Extremity
/ surgery
Male
Middle Aged
Peripheral Arterial Disease
/ surgery
Retrospective Studies
Walk Test
Walking
Wearable Electronic Devices
Journal
PM & R : the journal of injury, function, and rehabilitation
ISSN: 1934-1563
Titre abrégé: PM R
Pays: United States
ID NLM: 101491319
Informations de publication
Date de publication:
10 2019
10 2019
Historique:
received:
06
09
2018
accepted:
21
12
2018
pubmed:
8
2
2019
medline:
28
7
2020
entrez:
8
2
2019
Statut:
ppublish
Résumé
People with dysvascular lower limb amputation (LLA) achieve one-third of the recommended steps per day and experience severe disability. Although physical function improves with rehabilitation after dysvascular LLA, physical activity remains largely unchanged, and factors contributing to limited daily step count are unknown. To identify factors that contribute to daily step count after dysvascular LLA. Cross-sectional, secondary data analysis. Outpatient rehabilitation facilities. Fifty-eight patients with dysvascular major LLA (age: 64 ± 9 years, body mass index: 30 ± 8 kg/m Data were collected by a blinded assessor after dysvascular LLA. Candidate explanatory variables included (1) demographics, (2) LLA characteristics, (3) comorbidities and health behaviors, and (4) physical function. Variables with univariate associations with log steps/day (transformed due to non-normality) were included in a multiple linear regression model using backward elimination to identify factors that explained significant variability in log steps/day. The primary outcome, daily step count, was measured with accelerometer-based activity monitors worn by participants for 10 days. Participants took an average (± SD) of 1450 ± 1309 steps/day. After backward elimination, the final model included four variables explaining 62% of the overall daily step count (P < .0001): 2-minute walk distance (32%), assistive device use (11%), cardiovascular disease (10%), and pre-amputation walking time (11%). Average daily step count of 1450 steps/day reflects the lowest category of sedentary behavior. Physical function, cardiovascular disease, and pre-amputation walking time explain 62% of daily step count after dysvascular LLA. Although physical rehabilitation commonly focuses on improving physical function, interventions to increase daily step count after dysvascular LLA should also consider chronic disease and health behaviors that predate LLA. III.
Sections du résumé
BACKGROUND
People with dysvascular lower limb amputation (LLA) achieve one-third of the recommended steps per day and experience severe disability. Although physical function improves with rehabilitation after dysvascular LLA, physical activity remains largely unchanged, and factors contributing to limited daily step count are unknown.
OBJECTIVES
To identify factors that contribute to daily step count after dysvascular LLA.
DESIGN
Cross-sectional, secondary data analysis.
SETTING
Outpatient rehabilitation facilities.
PARTICIPANTS
Fifty-eight patients with dysvascular major LLA (age: 64 ± 9 years, body mass index: 30 ± 8 kg/m
METHODS
Data were collected by a blinded assessor after dysvascular LLA. Candidate explanatory variables included (1) demographics, (2) LLA characteristics, (3) comorbidities and health behaviors, and (4) physical function. Variables with univariate associations with log steps/day (transformed due to non-normality) were included in a multiple linear regression model using backward elimination to identify factors that explained significant variability in log steps/day.
PRIMARY OUTCOME MEASURE
The primary outcome, daily step count, was measured with accelerometer-based activity monitors worn by participants for 10 days.
RESULTS
Participants took an average (± SD) of 1450 ± 1309 steps/day. After backward elimination, the final model included four variables explaining 62% of the overall daily step count (P < .0001): 2-minute walk distance (32%), assistive device use (11%), cardiovascular disease (10%), and pre-amputation walking time (11%).
CONCLUSIONS
Average daily step count of 1450 steps/day reflects the lowest category of sedentary behavior. Physical function, cardiovascular disease, and pre-amputation walking time explain 62% of daily step count after dysvascular LLA. Although physical rehabilitation commonly focuses on improving physical function, interventions to increase daily step count after dysvascular LLA should also consider chronic disease and health behaviors that predate LLA.
LEVEL OF EVIDENCE
III.
Identifiants
pubmed: 30729727
doi: 10.1002/pmrj.12121
pmc: PMC8259321
mid: NIHMS1717650
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
1050-1058Subventions
Organisme : NCATS NIH HHS
ID : TL1 TR002533
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1-TR001082
Pays : United States
Organisme : NICHD NIH HHS
ID : K12 HD055931
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR001082
Pays : United States
Organisme : RRD VA
ID : I21 RX002054
Pays : United States
Organisme : RRD VA
ID : RX002054-01A1
Pays : United States
Informations de copyright
© 2019 American Academy of Physical Medicine and Rehabilitation. This article has been contributed to by US Government employees and their work is in the public domain in the USA.
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