Barriers and Enablers to Community Walking in People With Lower Limb Amputation

Research ObjectivesTo determine barriers and enablers to community walking perceived by people with lower limb amputation.DesignQualitative study involving three focus groups. Data collection was ceased when data saturation was achieved. Transcripts were analysed using thematic analysis underpinned by phenomenology.SettingMetropolitan area, Australia.Participants14 people with lower limb amputation, living in the community (age range 32-71years; K level 1-4; 4-24 months since amputation; 6 Minute Walk Test 50-505m; 9 males; 2 bilateral amputations; 1 person lived rurally).InterventionsN/A.Main Outcome Measure(s)Participants were asked to talk about their experiences walking in the community, and what they felt made walking in the community more and less difficult.ResultsThree main themes were identified and align with the International Classification of Functioning, Disability and Health (ICF) framework: personal factors, environmental factors and health condition. Personal barriers included time, finance and adjusting to change. Personal enablers included having a purpose, motivation and previous exercise beliefs. Environmental barriers were both physical (e.g. terrain, ambience, density) and social (e.g. lack of social support and awareness). Environmental enablers included preparation, aids/equipment and social support. Barriers related to health condition included prosthesis-related factors, residual limb integrity, other medical issues, fitness, pain and falls. Interestingly, many participants suggested that falls were an expected part of the journey. Health condition enablers included strength and fitness. Participants reported strategies they use to negotiate personal, environmental and health condition barriers.ConclusionsWalking in the community with a lower limb amputation presents many barriers, but enablers have also been identified. Targeted assessments and interventions and appropriate environmental planning may assist in minimising barriers to community walking