Cycling of people with a lower limb amputation in Thailand.

Jutamanee Poonsiri,Rienk Dekker,Pensupa Pimchan,Jan H B Geertzen,Chanapak Dismanopnarong,Yasmin Nutchamlong,Pieter U Dijkstra,Chiraphan Puttipaisan,Juha M Hijmans,Samai Suakonburi

doi:10.1371/journal.pone.0220649

Abstract

AimTo investigate cycling participation and barriers, and facilitators in adults with a lower limb amputation in Thailand.MethodQuestionnaires were given to 424 adults with uni/bilateral lower limb amputation from midfoot to hip disarticulation level at five public hospitals in Bangkok and prosthetic mobile units in Thailand. Participant characteristics were summarized using descriptive statistics. Variables associated with cycling (p<0.1) were entered in a logistic regression model.ResultsParticipants who cycled (46.7%, N = 197), mostly used their walking prostheses (91.9%, n = 188). Of cyclists, 92.4% had cycled before the amputation. Cyclists started cycling after the amputation by themselves (86.7%) mostly in order to increase/maintain health (67.0%). Most cyclists cycled on quiet roads. The most frequent destination was shops/market (64.1%). More facilitators were reported than barriers. Most reported barriers were related to health problems and negative attitudes toward cycling. Most reported facilitators were related to perceived health benefits and positive attitude toward cycling. The likelihood of cycling after the amputation increased in people who cycled before the amputation, were amputated lower than the knee, used a prosthetic foot with axis/axes, were amputated due to trauma, had income higher than 415 euro/month, and who reported a higher numbers of facilitators.ConclusionAfter a lower limb amputation, nearly half of people cycled. People with a below knee amputation due to trauma with prior cycling experience and higher income tended to cycle after the amputation. People who perceived more facilitators were more likely to cycle. Although cyclists could use a walking prosthesis to cycle, a prosthetic foot with a greater range of motion than the SACH increased the cycling likelihood.

Highlights

Cycling is one of the common activities of people with a lower limb amputation (LLA), as a recreational activity, sport, physical activity and way of transportation [1,2,3,4,5,6]
Most reported facilitators were related to perceived health benefits and positive attitude toward cycling
The likelihood of cycling after the amputation increased in people who cycled before the amputation, were amputated lower than the knee, used a prosthetic foot with axis/axes, were amputated due to trauma, had income higher than 415 euro/month, and who reported a higher numbers of facilitators

Summary

Introduction

Cycling is one of the common activities of people with a lower limb amputation (LLA), as a recreational activity, sport, physical activity and way of transportation [1,2,3,4,5,6]. Dutch non-disabled commuters perceived time and distance between home and work as major barriers to cycle, while perceived health benefits positively influenced participation in cycling [10]. Studies in people with a LLA, focused mainly on factors related to prosthetic or bicycle components influencing cycling [12,13,14,15]. Adjusting the bicycle crank arm allowed people with knee flexion limitation to cycle [13] or to reduce cycling asymmetry [14]. Influence of natural environment and infra-structure on cycling participation has not been investigated in people with a LLA [16]

Methods

Results

Conclusion