Prosthetic Categories

The Current State of Fall Training

    It’s easy to assume that all individuals with limb loss get fall training after amputation. Unfortunately, that is not the case, and a recently published study proves it.

     Fall training is an effective yet mostly overlooked fall intervention for lower-limb amputees.

    People with lower-limb loss risk accidental falls more than their non-disabled peers. A study published in 2001 found that more than 52% of lower-limb amputees experience at least one fall every year, making it more than twice the rate of non-disabled elderly individuals.

    To mitigate injuries from such falls, some people employ technical solutions to protect vulnerable areas of the body, like wearing padded garments, or pharmaceutical solutions, such as taking vitamin D to strengthen the bones. However, there is another effective yet mostly overlooked fall intervention — fall training.

    So, researchers investigated how many individuals with limb loss have received fall training and what factors prevent its wider adoption.

    The study  

    To collect data, the researchers developed an online questionnaire targeting people with lower-limb loss nationwide. Out of the 180 responses, 166 were included in the analysis. More than two-thirds of the respondents reported not receiving fall training.

    The researchers noted that considering the high incidence rate of falls among lower-limb amputees and the economic costs of falls, the numbers suggest an untapped potential in improving post-amputation care and long-term patient outcomes.

    The researchers also found a discrepancy in whether fall training was received and who provided it. Numerous respondents stated not receiving proper fall training but listed a provider anyway.

    Among the respondents, only 20 stated that they are taking tai chi or martial arts training, which have been deemed effective in helping mitigate injuries from accidental falls.  

    Other fall interventions  

    Fall training helps individuals assess any situation and avoid falls. If falls happen, however, this training will provide techniques to mitigate injuries.

    Fall training is comparable and compatible with other strategies, including Krav Maga, tai chi, and martial arts, to minimize the impact of falls on prosthetic users. Different methods can also help, including using the correct prosthetic components to improve balance, gait stability, and proprioception.

    In 2019, researchers found that using microprocessor knees helped increase walking speed on flat and uneven terrain, improved balance perception, and reduced accidental falls. This finding is supported by another study that found 82 fewer falls per 100 people with microprocessor knees. 

    However, the drawback of microprocessor knees is their high cost. Compared to expensive prosthetic technology, fall training costs more reasonably. Despite the cost-effectiveness of fall training, it is still underused, wasting patients’ rehabilitation potential.

    Who should be responsible for fall training?  

    Many assume that fall training is a domain of physical therapists who provide prosthetic gait retraining and other limb-loss therapy interventions. But, only some prosthesis users have the means to receive physical therapy. The study highlighted that only 79% of the respondents received physical therapy. Furthermore, according to 27% of the respondents, only some physical therapy programs include proper fall training.  

    Although fall training does not reduce the number of accidental falls, it effectively reduces the severity of injuries from falls. It’s essential to bring this issue into the consciousness of a larger public, and hopefully, this information will help you advocate for yourself or a loved one.