Inclusion Criteria:  unilateral, transtibial, or transfemoral LLA diagnosis of diabetes mellitus or peripheral artery disease age 50 to 89 years able to ambulate around the home with or without an assistive device at least one year since LLA  Exclusion Criteria:  trauma or cancer-related etiology of the LLA decisionally challenged individuals (SLUMS score in "Dementia" range) prisoners active cancer treatment clinical discretion of principle investigator to exclude patients who are determined to be unsafe and/or inappropriate to participate in the described intervention