Abstract
A relationship between walking ability and self-efficacy has been demonstrated in various rehabilitation patient populations. In experienced prosthetic ambulators, walking ability is related to self-efficacy of balance, however, this relationship has not been quantified for those with newly acquired lower limb amputations (LLA). To investigate the association between walking performance (objective) and self-reported walking abilities (subjective) on balance self-efficacy in those with LLA. Cross-sectional study of 27 people (17 men; mean age=63.57±9.33) at discharge from inpatient prosthetic rehabilitation for first major unilateral LLA. Individuals completed 6m straight path walking and the L-Test under single- and dual-task conditions. The Prosthesis Evaluation Questionnaire (PEQ) was administered, and the Ambulation subscale provided subjective measures of walking ability. A single PEQ question on satisfaction with walking (16B) was also used as a proxy for subjective walking ability. The Activities-specific Balance Confidence Scale measured balance self-efficacy. Multivariable linear regression was used to evaluate the strength of association between walking ability (objective and subjective) and balance self-efficacy (dependent variable). Walking velocity on the 6m straight path under single-task (p=0.011) and dual-task conditions (p=0.039), the single-task L-Test (p=0.035) and self-reported satisfaction with walking (p=0.019) were associated with self-efficacy of balance. Objective measures of walking ability that were independently associated with balance self-efficacy included straight path walking velocity under single and dual-task conditions and the single-task L-Test. Satisfaction with walking was also associated with balance self-efficacy. This highlights the interplay between physical and psychological factors during rehabilitation. More research in the area of self-efficacy and walking ability is needed to establish self-efficacy as a target during prosthetic rehabilitation for those with LLA.
Highlights
Individuals encounter significant physical, psychological and social consequences following the loss of a limb.[1]
A relationship between walking ability and self-efficacy has been demonstrated in various rehabilitation patient populations
Multivariable linear regression was used to evaluate the strength of association between walking ability and balance self-efficacy
Summary
Individuals encounter significant physical, psychological and social consequences following the loss of a limb.[1]. While mobility and function improve during rehabilitation, the LLA population may experience difficulties with gait that persist long-term.[6,7] Falls are a particular concern in this population, as over half of those with LLA fall at least once annually.[8,9] After a fall, older individuals without LLA may limit their walking due to impact on self-efficacy and a fear of falling.[9] walking is crucial for social participation and maintaining QOL in those with LLA.[10] As such, the impact of psychological factors on walking ability in this population have been investigated. In experienced prosthetic ambulators, walking ability is related to self-efficacy of balance, this relationship has not been quantified for those with newly acquired lower limb amputations (LLA)
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