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Gait speed as an indicator of prosthetic walking potential following lower limb amputation

Background: The relationship between gait speed and prosthetic potential (K-level classifications) and function has not been explored among people transitioning from hospital rehabilitation to the community. Objectives: To examine gait speed at discharge from inpatient rehabilitation among people prescribed a prosthetic leg after unilateral lower limb amputation, and associations between gait speed, prosthetic potential and functional ability. Study design: Cohort. Methods: Gait speed (10-m walk test), K-level (Amputee Mobility Predictor) and Functional Independence Measure motor were compared for 110 people (mean (standard deviation) age: 63 (13) years, 77% male, 71% transtibial amputation, 70% dysvascular causes). Results: Median (interquartile range) gait speed and Functional Independence Measure motor were 0.52 (0.37–0.67) m/s and 84 (81, 85), respectively. Median (IQR) gait speed scores for each K-level were as follows: K1 = 0.17 (0.15–0.19) m/s, K2 = 0.38 (0.25–0.54) m/s, K3 = 0.63 (0.50–0.71) m/s and K4 = 1.06 (0.95–1.18) m/s. Median (IQR) FIM-Motor scores for each K-level were as follows: K1 = 82 (69–84), K2 = 83 (79–84), K3 = 85 (83–87) and K4 = 87 (86–89). Faster gait speed was associated with higher K-level, higher FIM-Motor, being younger, male and having transtibial amputation with nonvascular aetiology. Conclusion: Gait speed was faster among each higher K-level classification. However, gait speeds observed across all K-levels were slower than healthy populations, consistent with values indicating high risk of morbidity and mortality. Clinical relevance Factors associated with faster gait speed are useful for clinical teams considering walking potential of people with lower limb prostheses and those seeking to refine prosthetic rehabilitation programmes.