Investigation of Physical Activity and Associated Factors in Lower Extremity Amputees
Condition: Amputee
Study type: Observational

Summary: 
      The aim of this study was to investigate the physical activity and related factors of
      individuals with lower extremity amputation.

      Participants in the study who have signed a voluntary consent form will be informed about the
      study first.Then, demographic information form will be started to be recorded in order to
      inform the socio-demographic characteristics of the participants and the information about
      amputation and prosthesis. The participants will be given the Timed Up and Go Test, L Test,
      Functional Reach Test and 2 Minute Walk Test. Following these tests, participants will
      continue with the scales to be answered by the participants themselves.These are
      respectively; Activity-Specific Balance Confidence Scale, Trinity Amputation and Prosthesis
      Experience Scale and Amputee Body Image Scale.Before the data is collected, individuals will
      be informed about the equipment to be used in the tests.An adequate number of trials will be
      conducted before the evaluation and use of the equipment in order to be familiar with the
      equipment. All assessments will be made by the same physiotherapist.
    

Detailed description: 
      Amputation affects the quality of life of the individual; It is an important surgical
      intervention that can lead to functional, psychological and social isolation. The prevalence
      and incidence of amputation is difficult to determine precisely at the international
      level.The etiology of amputation varies depending on geographical location.Peripheral
      vascular diseases are the most common causes of amputation in developed countries and trauma
      in developing countries.Limitations in body composition and function after amputation
      decrease the activity level, so the participation of amputees is negatively affected.Physical
      activity refers to any activity involving body movement and increasing the heart rate and
      respiratory rate of the individual.

      Most of the lower extremity amputated patients had low levels of physical activity and
      participation in sports activities; It was also found that individuals with lower extremity
      amputations were less active than those without lower extremity amputation.However, there are
      few studies that have shown that individuals with lower extremity amputation are regularly
      active, and the amputation of amputated individuals in these studies has mostly caused
      traumatic amputations.

      Lower extremity amputation; Although there is significant evidence showing that the risk of
      developing a number of chronic degenerative diseases such as cardiovascular disease,
      diabetes, hypertension, obesity and osteoarthritis significantly increases, there are few
      studies investigating and investigating physical activity after amputation.Despite these
      investigations, relatively little is known about the components or models of physical
      activity necessary to provide protection against chronic diseases and to improve metabolic
      health in these specific population groups. Therefore, accurate measurement and estimation of
      the level of physical activity and energy expenditure is critical in the prevention and
      prevention of chronic diseases in individuals with lower extremity amputation.

      A higher level of physical activity is associated with better perceived quality of life in
      individuals with lower extremity amputation.Therefore, it is important to develop physical
      activity in individuals with lower extremity amputations.

      Although there are studies investigating the physical activity in individuals with lower
      extremity amputation as a result of our literature review, no study has been found
      investigating factors related to physical activity.

      The aim of this study was to investigate the physical activity and related factors of
      individuals with lower extremity amputation.

      RESEARCH QUESTIONS

      Question 1: What is the level of physical activity in individuals with lower extremity
      amputation?

      Question 2: What are the factors associated with the level of physical activity in amputees
      of the lower extremity?

      THE UNIVERSE AND THE SAMPLING OF RESEARCH

      The individuals to be included in the study will be selected from voluntary amputees who
      apply to the Prosthesis-Orthotics Biomechanics Unit of the Department of Physiotherapy and
      Rehabilitation of the Eastern Mediterranean University Faculty of Health Sciences.

      As the sample volume in the study was to be linear regression analysis by using G-Power
      program, it was determined that the total determinant factor number would be 8 and 108 people
      as alpha, 0.05, beta: 0.80 and effect size as 0.15.

      METHOD OF RESEARCH

      Participants in the study who have signed a voluntary consent form will be informed about the
      study first.Then, demographic information form will be started to be recorded in order to
      inform the socio-demographic characteristics of the participants and the information about
      amputation and prosthesis.The participants will be given the Timed Up and Go Test, L Test,
      Functional Reach Test and 2 Minute Walk Test. Following these tests, participants will
      continue with the scales to be answered by the participants themselves.These are
      respectively; Activity-Specific Balance Confidence Scale, Trinity Amputation and Prosthesis
      Experience Scale and Amputee Body Image Scale.Before the data is collected, individuals will
      be informed about the equipment to be used in the tests.An adequate number of trials will be
      conducted before the evaluation and use of the equipment in order to be familiar with the
      equipment. All assessments will be made by the same physiotherapist.

      INCLUDING CRITERIA

        -  Use prosthesis for at least 6 months

        -  18 years to 85 years

        -  Independent walking distance of 30 meters

        -  Individuals with unilateral amputation will be included.

      EVALUATIONS IN THE RESEARCH

      In this study, age, gender, height, body weight, body mass index, educational status, marital
      status, profession, socio-demographic characteristics of the dominant side, as well as the
      history of amputation, cause of amputation, amputation side and level, stump shape, phantom
      pain Factors related to amputation, such as phantom sensation, type of prosthesis and
      duration of use will be recorded with the form prepared.

      Timed Up and Go Test: Timed Up and Go Test will be used to measure the risk of functional
      mobility and fall.The participant seated on the chair without clinging to his arms 3m from
      the ground, 3m after walking without touching a place to return, the chair will be asked to
      go back to the sitting position and the time will be recorded in seconds..

      L Test: The L test will be used to assess functional mobility. In the L-shaped direction, the
      participants will be carried out on the ground where the long edge of L is 7 meters and the
      short edge will be 3 meters. At the beginning of the test, the participants will sit in a
      chair without arms and stand up from the chair with the start command, complete the L shape
      at the preferred speed and return to the chair without interruption. Thus, a total distance
      of 20 meters will be completed at the end of the test. The completion time of the test will
      be recorded.The intrarater reliability of the test was found to be 0.97 and the interrater
      reliability was 0.96, and it was shown to have a very high validity.

      Functional Reach Test: The Functional Reach Test will be done to evaluate the stability
      limits and fall risks of individuals.For the test, individuals will be asked to stand upright
      on their shoulders with their shoulders wide open.In this position, the acromion level of
      individuals will be marked on the wall.Individuals will be asked to lift their arms forward
      to the marked level and to reach forwards without moving their feet.The distance between the
      start and end position will be measured and recorded in cm.The test will be repeated 3 times
      and the measurements will be averaged.The test will be repeated if individuals touch the wall
      or take steps during the test.

      2-Minute Walk Test: 2 Minute Walk Test will be used to evaluate the functional capacity of
      individuals.The patient will be seated in the chair at the 25-meter track where the test will
      be done and the distance within 2 minutes will be measured in meters.Before and after the
      test, the patient's pulse and oxygen saturation with pulse oximetry will be measured and
      recorded using the Borg Scale.

      Activity-Specific Balance Confidence Scale: In order to evaluate the reliability of the
      balance, the Activity-Specific Balance Confidence Scale, which has been validated for Turkish
      reliability and validity, will be used.There are 16 functional activities in the scale. Each
      individual will have 16 different activities and the reliability will be evaluated
      accordingly.Measurement results from 0% to 100% are given.0% ir 'no trust' 'and 100% 100'
      completely sure ''.If this scale gives a score above 80%, then it is mentioned that the
      balance is reliable.For internal consistency, the Cronbach's alpha value was 0.9649 for the
      test and 0.9648 for the retest.

      Trinity Amputation and Prosthesis Experience Scale: In order to evaluate the quality of life,
      the Trinity Amputation and Prosthesis Experience Scale which is a validity and validity scale
      in amputees will be used. Trinity Amputation and Prosthesis Experience Scale two consists of
      parts.In the first part; psychosocial adjustment, activity restriction and prosthesis
      satisfaction.In the second part; questions about how many hours the prosthesis is worn,
      general health and physical capacity. For internal consistency, Cronbach's alpha value for
      psychosocial adjustment; 0.862 for activity restriction; 0.894 and 0.915 for prosthetic
      satisfaction.

      Amputated Body Image Scale: The Amputee Body Image Scale, which has been validated for
      Turkish validity and reliability, will be used to assess body image disorders in amputees.
      This 20-item scale evaluates the situations that the amputee perceives and feels about the
      body. The score obtained varies between 20-100. A high score indicates a poor body image. The
      Cronbach alpha value was 0.939.

      Assessment of Physical Activity: Sociodemographic data such as age, height, weight and gender
      from subjects will be recorded on the accelerometer profile using Stay Healthy software
      (Research Tracker 6, Version 3.1, Stay Healthy, Inc., Monrovia, USA). The data will be
      collected in computer environment as total calorie and efficiency count (VM; X axis, Y axis,
      Z axis).The total calories will be recorded in kilocalories, while the data count will be
      recorded in terms of acceleration.
    

Observational model: Other
Time perspective: Cross-Sectional
Sampling method: Probability Sample
Study population: 
        Lower Limb Amputees
      
Keywords: Physical activity; Prosthesis