Virginia Commonwealth University
Despite high medical expenses (\>$500K/patient), mobility improvements achieved during rehabilitation for people with lower limb amputation (LLA) fail to translate into improved real-world outcomes. Even with advances in prosthesis technology enabling faster gait speed, greater walking endurance, and improved mobility confidence, people with LLA report persistent dissatisfaction with real-world mobility, limited ability to walk in the community, and difficulty achieving recommended physical activity levels. Real-world walking requires thinking and moving simultaneously (e.g., cognitive-motor dual-tasking), visually attending to the environment, and navigating varying terrain. In contrast, clinical mobility assessments are usually performed without additional visual or cognitive demands, in controlled environments, and on level surfaces. Current clinical tools used to assess ambulation progression during rehabilitation do not adequately assess these changes in people who have experienced LLA.
A step toward rectifying a critical gap in care for those with LLA by quantifying the effect of vision-based and non-vision-based cognitive-motor dual-tasking and high and low complexity terrain on gait speed and gaze behavior. Cognitive-motor dual-task assessment paradigms are well-established in other populations and often used to better approximate real-world walking demands. However, the type of cognitive task used is an important factor. The most common methods for dual-task assessment in people with LLA are limited to cognitive tasks lacking overt visual attention (e.g., serial subtracti…
Inclusion Criteria: * unilateral transtibial LLA of either dysvascular (diabetes, peripheral vascular disease, and/or infection) or traumatic etiology * 18 years old minimum * able to ambulate 2 minutes without rest * 9 months since LLA * fitted with terminal prosthesis * 20/60 vision or better (with or without glasses/contacts) Exclusion Criteria: * congenital or cancer-related LLA * ankle-level or above LLA on the contralateral limb * residual limb wound or contralateral foot ulcer * unstable heart condition (including unstable angina, uncontrolled cardiac dysrhythmia, acute myocarditis,…
Assessment of accelerometry: Daily duration (minutes) of sitting, standing, stepping, Daily step count, Daily walking bouts stepping cadence, Timed Up and Go and Two-minute Walk Test
Comprehensive assessment of eye movements during walking including Target Fixation Time (seconds; %) and Number of fixations
The following assessments will be completed: World health organization disability assessment schedule 2.0 (WHODAS), and Activities Specific Balance Confidence Scale.
Arctuva estimate
Verify or correct the compensation shown for this listing.