Fall-related events in people who are lower limb prosthesis users: the lived experience

Abstract

Purpose

To explore lived experiences, and identify common themes as well as vocabulary associated with fall-related events in lower limb prosthesis (LLP) users.

Materials and methods

Five focus groups of LLP users from across the United States were conducted remotely via video or tele-conferencing. Focus group transcripts were coded and analyzed using methods adapted from a grounded theory approach to identify themes.

Results

Focus group participants (n = 25) described experiences associated with fall-related events that resulted in the identification of six themes: (1) memories of fall-related events are shaped by time and context, (2) location and ground conditions influence whether falls occur, (3) some activities come with more risk, (4) fall-related situations are multi-faceted, and often involve the prosthesis, (5) how LLP users land, but not the way they go down, tends to vary, and (6) not all falls affect LLP users, but some near-falls do.

Conclusion

Consideration for where LLP users fall, what they are doing when they fall, how they fall, what occurs as a result of a fall, and how well memory of a fall persists may enhance recording and reporting of falls, contribute to development of improved fall risk assessment tools, and inspire the design and function of prosthetic componentry for patient safety.

Implications for rehabilitation

• Falls are a common problem in lower limb prosthesis (LLP) users that can lead to adverse health outcomes.

• Concerns over near falls, not just falls, may merit greater attention from rehabilitation professionals.

• Elements of the lived experience that appear unique to LLP users include the role of prosthetic fit, function, and comfort in losing and/or recovering balance; as well as the tendency of LLP users to modify rather than stop or avoid activities associated with falls.

Keywords:

• Accidental falls
• amputation
• qualitative research
• artificial limb

Acknowledgements

The work described in this manuscript has not been previously published, nor is it under consideration for publication elsewhere. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Otto Bock Healthcare LP and Össur R&D. All study procedures were reviewed and approved by a University of Illinois at Chicago institutional review board.

Author contributions

Study Concept and Design by A. Sawers, B. Hafner. Acquisition of data by A. Sawers, J. Kim, B. Hafner. Analysis and interpretation of data by A. Sawers, J. Kim, C. McDonald. Drafting of manuscript by J. Kim, A. Sawers. Critical revision of manuscript of important intellectual content by B. Hafner, C. McDonald. Statistical analysis by A. Sawers. Study supervision by A. Sawers.

Disclosure statement

The authors declare that there is no conflict of interest.

Data availability statement

All data associated with this manuscript reside with the authors.

Additional information

Funding

Research reported in this publication was supported by Otto Bock Healthcare LP and Össur R&D.