Düşen ve düşmeyen transtibial protez kullanıcılarında karakteristik özelliklerin ve yaşam kalitesinin karşılaştırılması

Year 2026, Volume: 13 Issue: 1 , 25 - 31 , 16.04.2026

Yasin Yurt , Cansu Koltak , Özge Çiftçi , Tuğba Paksoy , Merve Paksoy

https://doi.org/10.15437/jetr.1598812

https://izlik.org/JA62WP97NL

Abstract

Amaç: Alt ekstremite protezi kullanıcılarında düşmeler ve düşmeye bağlı yaralanmalar yaygındır. Transtibial protez kullanıcılarında (TTPK) düşme nedenleri ve bunların sağlıkla ilişkili yaşam kalitesi üzerindeki etkisi net değildir. Bu çalışmada, düşen ve düşmeyen TTPK arasındaki karakteristik farklılıkları ve yaşam kalitesini karşılaştırmayı amaçladık.
Yöntem: Çalışmaya 36 TTPK katıldı. Son bir yıl içinde en az bir kez düşen bireyler düşenler olarak sınıflandırıldı. Fonksiyonel seviye, İki Dakika Yürüme Testi, Süreli Kalk Yürü Testi ve Fonksiyonel Uzanma Testi ile değerlendirildi.
Bulgular: Katılımcıların 16’sı (%44,44) düşen olarak belirlendi. Düşenlerin yaşı daha yüksekti ve Süreli Kalk Yürü Testi süreleri daha uzundu (p<0,05). Çalışma durumu, amputasyon nedeni, diyabet prevalansı ve yürüme yardımcısı kullanımı açısından düşenler ile düşmeyenler arasında anlamlı farklılıklar bulundu (p<0,05). Gruplar arasında yaşam kalitesi seviyeleri benzerdi (p>0,05).
Sonuç: İleri yaş, azalmış fonksiyonel seviye, çalışmama durumu, vasküler nedenli amputasyon, diyabet varlığı ve yürüme yardımcısı kullanımı düşen transtibial protez kullanıcılarındaki karakteristik farklılıklardır

Keywords

Amputasyon , Protez , Düşmeler , Yaşam kalitesi

Comparison of characteristic features and quality of life in faller and non-faller transtibial prosthesis users

https://izlik.org/JA62WP97NL

Abstract

Purpose: Falls and fall-related injuries are common among lower limb prosthesis users. However, the reasons of falls and their impact on health-related quality of life in transtibial prosthesis users (TTPU) remain unclear. We aimed to compare the characteristic differences and quality of life between faller and non-faller TTPU.
Methods: Thirty-six TTPU participated in the study. Subjects who had fallen at least once in the past year were classified as fallers. Functional levels were assessed using the Two-Minute Walk Test, the Timed Up & Go Test, and the Functional Reach Test.
Results: Sixteen (44.44%) participants were identified as fallers. Fallers had higher age and had longer TUG test durations compared to non-fallers (p<0.05). Differences in working status, reason for amputation, prevalence of diabetes, and walking aid use were significant between fallers and non-fallers (p<0.05). Quality of life levels were similar between the groups (p>0.05).
Conclusion: Older age, decreased functional level, not working, having a vascular amputation, having diabetes, and using any walking aid were identified as the characteristic differences of faller transtibial prosthesis users.

Keywords

Amputation , Prosthesis , Falls , Quality of life

References

• Vanicek N, Strike S, McNaughton L, et al. Gait patterns in transtibial amputee fallers vs. non-fallers: biomechanical differences during level walking. Gait Posture. 2009;29:415-420.
• Hunter SW, Batchelor F, Hill KD, et al. Risk factors for falls in people with a lower limb amputation: a systematic review. PM&R. 2017;9:170-180.
• Miller WC, Speechley M, Deathe B. The prevalence and risk factors of falling and fear of falling among lower extremity amputees. Arch Phys Med Rehabil. 2001;82:1031-1037.
• Sawers A, Hafner BJ. Using clinical balance tests to assess fall risk among established unilateral lower limb prosthesis users: cutoff scores and associated validity indices. PM&R. 2020;12:16-25.
• Wong CK, Chihuri ST, Li G. Risk of fall-related injury in people with lower limb amputations: a prospective cohort study. J Rehabil Med. 2016;48:80-85.
• Chihuri S, Wong CK. Factors associated with the likelihood of fall-related injury among people with lower limb loss. Inj Epidemiol. 2018;5:42.
• Mundell B, Maradit Kremers H, Visscher S, et al. Direct medical costs of accidental falls for adults with transfemoral amputations. Prosthet Orthot Int. 2017;41:564-570.
• van Velzen JM, van Bennekom CA, Polomski W, et al. Physical capacity and walking ability after lower limb amputation: a systematic review. Clin Rehabil. 2006;20:999-1016.
• Pezzin LE, Dillingham TR, MacKenzie EJ. Rehabilitation and the long-term outcomes of persons with trauma-related amputations. Arch Phys Med Rehabil. 2000;81:292-300.
• Yu JC, Lam K, Nettel-Aguirre A, et al. Incidence and risk factors of falling in the postoperative lower limb amputee while on the surgical ward. PM&R. 2010;2:926-934.
• Pauley T, Devlin M, Heslin K. Falls sustained during inpatient rehabilitation after lower limb amputation: prevalence and predictors. Am J Phys Med Rehabil. 2006;85:521-532.
• Clemens S, Gaunaurd I, Raya M, et al. Using theoretical frameworks to examine fall history and associated prosthetic mobility in people with nondysvascular lower limb amputation. Prosthet Orthot Int. 2022;46:484-490.
• Quai TM, Brauer SG, Nitz JC. Somatosensation, circulation and stance balance in elderly dysvascular transtibial amputees. Clin Rehabil. 2005;19:668-676.
• Wong CK, Chihuri ST. Impact of vascular disease, amputation level, and the mismatch between balance ability and balance confidence in a cross-sectional study of the likelihood of falls among people with limb loss. Am J Phys Med Rehabil. 2019;98:130-135.
• Parker K, Hanada E, Adderson J. Gait variability and regularity of people with transtibial amputations. Gait Posture. 2013;37:269-273.
• Hordacre BG, Barr C, Patritti BL, et al. Assessing gait variability in transtibial amputee fallers based on spatial-temporal gait parameters normalized for walking speed. Arch Phys Med Rehabil. 2015;96:1162-1165.
• Dite W, Connor HJ, Curtis HC. Clinical identification of multiple fall risk early after unilateral transtibial amputation. Arch Phys Med Rehabil. 2007;88:109-114.
• Samitier CB, Guirao L, Costea M, et al. The benefits of using a vacuum-assisted socket system to improve balance and gait in elderly transtibial amputees. Prosthet Orthot Int. 2016;40:83-88.
• Ferraro C. Outcomes study of transtibial amputees using elevated vacuum suspension in comparison with pin suspension. J Prosthet Orthot. 2011;23:78-81.
• Brooks D, Parsons J, Hunter JP, et al. The 2-minute walk test as a measure of functional improvement in persons with lower limb amputation. Arch Phys Med Rehabil. 2001;82:1478-1483.
• Schoppen T, Boonstra A, Groothoff JW, et al. The Timed “up and go” test: reliability and validity in persons with unilateral lower limb amputation. Arch Phys Med Rehabil. 1999;80:825-828.
• Gremeaux V, Damak S, Troisgros O, et al. Selecting a test for the clinical assessment of balance and walking capacity at the definitive fitting state after unilateral amputation: a comparative study. Prosthet Orthot Int. 2012;36:415-422.
• Topuz S, Ulger O, Yakut Y, et al. Reliability and construct validity of the Turkish version of the Trinity Amputation and Prosthetic Experience Scales (TAPES) in lower limb amputees. Prosthet Orthot Int. 2011;35:201-206.
• Perkins NJ, Schisterman EF. The inconsistency of 'optimal' cutpoints obtained using two criteria based on the receiver operating characteristic curve. Am J Epidemiol. 2006;163:670-675.
• Maciver M, Dixon D, Powell D. Quality of life in young people with limb loss: a systematic review. Disabil Rehabil. 2023;22:1-12.
• Guner SG, Nural N. Fall in the elderly people: determining the status within the context of dissertations conducted in Turkey. Izmir Katip Celebi Univ J Health Sci. 2017;2:9-15.
• Ulger O, Topuz S, Bayramlar K, et al. Risk factors, frequency, and causes of falling in geriatric persons who has had a limb removed by amputation. Top Geriatr Rehabil. 2010;26:156-163.
• Rinkel WD, van Nieuwkasteele S, Cabezas MC, et al. Balance, risk of falls, risk factors and fall-related costs in individuals with diabetes. Diabetes Res Clin Pract. 2019;158:107930.
• Hausdorff JM, Rios DA, Edelberg HK. Gait variability and fall risk in community-living older adults: a 1-year prospective study. Arch Phys Med Rehabil. 2001;82:1050-1056.
• Jung D, Shin S, Kim H. A fall prevention guideline for older adults living in long-term care facilities. Int Nurs Rev. 2014;61:525-533.