The Association of Functional Mobility and Injurious Falls Among Adults With Lower-limb Amputation
Presenter: Taavy Miller, CPO, PhD
In this Thranhardt lecture presented Tuesday night following the President’s Welcome, Miller discussed data gathered from a large multisite clinical database to quantify the risk of injurious falls among adults with lower-limb amputations who wear prostheses based on different mobility categories. The study included 12,044 adults with unilateral amputations with a median time since amputation of five years and used two analytic approaches—quartiles as defined by the PLUS-M and clinically relevant levels, including characteristics such as amputation level, age, and functional classification, mapped to the PLUS-M scores.
Miller presented results that found that a lower functional mobility score was associated with an increased risk of injurious falls. From an economic standpoint, this is significant because injurious falls due to lower mobility put a greater burden on healthcare utilization. Additionally, in terms of patient outcomes, higher mobility levels contribute to better quality of life scores and appears to decrease the injurious fall rates of people with lower-limb amputations.
Miller stressed that one of the key takeaways from the presentation was that rehabilitation plans should target prosthesis use with goals that increase function and mobility. She said the knowledge points to the continued importance for clinicians to assess patients’ mobility and function, along with discussing their history of falls and other potential risk factors associated with falls. Prosthetists should aim to increase patient confidence and perceived ability to complete functional activities by considering optimal componentry along with potential therapy and other support, such as peer-to-peer connections.
Prosthetic Socket Fit Troubleshooting and Root Cause Analysis
Presenter: Brian Kaluf, CP, FAAOP
Kaluf’s presentation focused on the need for clinicians and patients to manage a variety of factors that can affect socket fit. A comprehensive understanding of the possibilities can help clinicians keep all factors in mind when troubleshooting, he said. Also, a systematic process of analyzing the root cause of the socket fit problem can help clinicians and patients identify the correct interventions.
He highlighted relevant research evidence and emerging innovative socket technologies, and included a step-by-step approach for determining the cause of a socket fit issue, for immediate applicability in clinical practice.
Kaluf developed the content of his presentation over the years through discussions with colleagues, clinical experience, and research publications, he said, but he included interactive polls and directed discussion points for the chat window to tap into the advantages of a virtual environment, and participated in a Q&A session following the presentation.
Roundtable discussions on the topic can be created any time on the ExperienceAAOP2021 meeting platform.