Walking Test May Help Prioritize Prosthetic Evaluations

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While Medicare Functional Classification Level (K-level) guidelines in the United States require demonstration of cadence variability to justify higher-level prosthetic componentry prescription, clinical assessment of cadence variability remains subjective. Currently, no clinical outcome measures are associated with cadence variability during community ambulation.

A recent study evaluated whether physical performance—ten-meter walk test-based walking speeds, L-Test, and Figure-of-8 Walk Test scores—is associated with community-based cadence variability among individuals with a transtibial amputation.

Forty-nine participants, ages 18–85 years, with a unilateral transtibial amputations were included in the study. Linear regression models were conducted to determine whether physical performance was associated with cadence variability (a unitless calculation from FitBit One minute-by-minute step counts), while controlling for gender, age, and time since amputation (pâ©˝ .013).

Beyond covariates, self-selected gait speed explained the greatest amount of variance in cadence variability (19.2%, p < .001), the study found. Other outcome measures explained smaller, but significant, amounts of the variance (11.1–17.1%, p = .001–.008). For each 0.1 m/s-increase in self-selected and fast gait speeds, or each 1-s decrease in L-Test and F8WT time, community-based cadence variability increased by 1.76, 1.07, 0.39, and 0.79, respectively (p < .013).

Researchers found that in clinical settings, faster self-selected gait speed best predicted increased cadence variability during community ambulation.

The study, performance-based outcome measures are associated with cadence variability during community ambulation among transtibial amputees, was published in Prosthetics and Orthotics International.