Fall Prevalence and Contributors to the Likelihood of Falling in Persons with Upper Limb Loss

While Nina Bondre, CPO is no longer with us at Dankmeyer, she left some columns behind so that we could continue to post topics of interest in the Dankmeyer Download space. This particular one concerns falls in those with upper limb loss.

Fall risk is often associated with lower limb amputees, both before and after provision of their prosthesis. Recent research has demonstrated that upper limb loss can also increase fall risk. Arm motion during walking helps to maintain balance, and when there is upper limb loss, this balance can be compromised. In those with upper limb loss, they rely more heavily on their legs to maintain balance. The results of this study point to the need for falls screening and encouraging physical therapy for improving balance and reducing fall risk.

The author surveyed 105 participants with upper limb loss (at or above the wrist) and found that 28.6% reported 2 or more falls in the past year. 45.7% fell at least once in the last year. These falls are likely associated with "reduced balance confidence, use of upper limb prostheses, and reduced physical capabilities". 30% of the reported falls occurred while walking outdoors, and 30% were during ascending or descending stairs. Most of the falls are associated with losing balance, tripping, or slipping. The recommendation from this study is to focus physical therapy on improving balance, and how to recover from trips and stumbles. 

The original research for this article can be found in the Oxford Academic and you can read it by clicking here.

This is a article in the April 2019 issue of PT in Motion that is written about the original research. You can further explore this topic by clicking here.