The prevalence and risk factors of falling and fear of falling among lowerextremity amputees

Objectives: To estimate the falling experience and fear of falling status a nd to describe characteristics associated with falling and fear of falling. Design: Population-based consecutive sample survey and chart review. Setting: Two Canadian, regional, university-affiliated outpatient amputee c linics. Participants: The sample (n = 435; mean age, 62 +/- 15.7yr) of community-li ving participants was mostly male (71%), had unilateral (below knee 73%; ab ove knee 27%) amputations primarily for vascular (53% vs 47% nonvascular) r easons. Intervention: Review patient charts and survey questionnaires to determine socio demographic information (eg, social support), information about the a mputation (eg, cause, level, problems), physical health and function (eg, p ain, limitations, comorbidity), and psychologic state (depression, adaptati on). Main Outcome Measures: Occurrence of a fall in the past 12 months and prese nce of a fear of falling. Results: Exactly 52.4% subjects reported falling in the past year, whereas 49.2% reported a fear of falling. Logistic regression analyses revealed fal ling was related to having an above knee amputation (odds ratio [OR] = 2.78 ; 95% confidence interval [CI] = 1.71-4.51), back (OR = 1.96; 95% CI = 1.08 -3.54) and joint (OR = 1.67; 95% CI = 1.01-2.74) pain, and multiple stump a nd prosthesis problems (OR = 3.09; 95% CI = 1.58-6.04). Having had the ampu tation greater than or equal to4 years in the past was protective (OR =.53; 95% CI =.29-89). Factors related to an increase risk of fear of falling in cluded having to concentrate on each step while walking (OR = 4.06; 95% CI = 2.46-6.71) and having a fall in the past 12 months (OR = 1.62; 95% CI = 1 .04-2.54), whereas being male (OR = 0.35; 95% CI =.21-57) and having good t o excellent perceived health (OR =.35; 95% CI =.21-58) were protective. Conclusions: Falling and fear of falling are pervasive among amputees. Comp rehensive and ongoing intervention and education should be considered. Rese arch is required to assess the consequences of falling and fear of falling.