Climbing stairs after outpatient rehabilitation for a lower-limb amputation

Objective: To study the necessity and ability to climb stairs in persons after a lower-limb amputation (LLA) and the relation of this ability with personal and clinical variables.

Design: Cross-sectional study.

Setting: Outpatient department of a rehabilitation center.

Participants: Persons with an LLA (N=155; mean age ± SD, 64.1 ± 11.2y; 73% men).

Interventions: Not applicable.

Main outcome measures: The necessity to climb stairs was assessed with the Prosthetic Profile of the Amputee. Several indicators of the ability to climb stairs were assessed including: (1) independence in climbing stairs with a handrail and (2) without a handrail, according to the Locomotor Capabilities Index; (3) numbers of floors actually climbed, according to a rating scale; and (4) limitations in climbing stairs, according to the Climbing Stairs Questionnaire (range, 0-100, with higher scores indicating less limitations). Multivariate logistic regression analysis was used to investigate the associations between the ability to climb stairs and personal and clinical variables.

Results: Of the participants, 47% had to climb stairs. The ability to climb stairs was: (1) 62% independently climbed stairs with a handrail and (2) 21% without a handrail; (3) 32% didn't climb any stairs, 34% climbed half a floor or 1 floor, and 34% climbed ≥ 2 floors; (4) the median sum score (interquartile range) of the Climbing Stairs Questionnaire was 38 (19-63), indicating marked limitations. Older participants and women were less able to climb stairs with and without a handrail.

Conclusions: A considerable number of persons with an LLA have to climb stairs in their home environment. Many of them, especially older participants and women, are particularly hampered in their ability to climb stairs.