Researchers developed an online self-management program for people with lower-limb loss, the Self-Management for Amputee Rehabilitation using Technology (SMART), and assessed its feasibility for improving walking capacity and confidence for adults with recent lower-limb loss.
Twelve community-dwelling adults with unilateral transtibial or transfemoral amputations participated. Self-management technology included six weekly online educational modules (e.g., pain management, diet, and sock management) and six weekly online meetings with a peer mentor to discuss goal setting and action planning. Outcomes were assessed at baseline (before SMART) and after six weeks using SMART.
Feasibility indicators included process (retention rate), resource (duration of training sessions), management (participant processing), and treatment issues (effect size). The primary clinical outcome was walking capacity measured using Timed Up and Go, and secondary outcome was walking confidence measured using the Ambulatory Self-Confidence Questionnaire.
The participants’ median age was 56 years with a range of 26-79 years. The retention rate was 100 percent. All participants were trained in less than 15 minutes. Four participants had an enrollment delay of more than ten days. Two participants reported non-injurious falls because of amputation comorbidities and increased activity. The effect sizes for walking capacity and confidence were 0.51 and 0.86, respectively.
The researchers concluded that SMART required only small intervention and protocol refinements, which will be incorporated for a future multisite randomized controlled trial.
The study, “Feasibility of self-management for amputee rehabilitation using technology and peer support for improving walking and confidence in individuals with lower limb loss,” was published in Prosthetics and Orthotics International.
