782 EP053 – Developing an exercise intervention using the delphi process to prevent bone mineral density loss in amputees: Implications for athletes

This is the authors' abstract. We don't add key points for this paper.

Background Lower-limb amputation reduces bone mineral density (BMD) on the amputated side (1). Exercise interventions are effective in improving BMD in able-bodied individuals (2). However, similar interventions have not been implemented in amputees. Prior to intervention implementation, it would be prudent to leverage relevant scientific evidence and clinical expertise to assist in intervention development. Objective To elicit expert opinion and gain consensus to define specific exercise prescription parameters to prevent BMD loss in amputees. Design and setting International e-Delphi expert consensus method. Participants 13 international experts (defined according to academic publications and/or clinical expertise in relevant areas, table 1). Interventions Round 1 involved asking participants to rate their level of agreement with 22 exercise prescription statements to improve amputee BMD using a 5-point Likert scale. Agreement was deemed as >3 on the scale (agree/strongly agree). Feedback was permitted in round 1. Statements of <50% agreement were excluded. Round 2 repeated remaining statements with the addition of round 1 feedback. Round 3 allowed participants to reflect on their round 2 responses considering group findings and whether they wished to change or maintain their response. Main Outcome Measurement Statements reaching ≥70% in round 3 were deemed to reach a consensus. Results Round 1 excluded 12 statements and added 1 extra statement for round 2 (11 statements for rounds 2–3). Round 3 reached a consensus on 9 statements to guide a future exercise intervention (Figure 1). Conclusions This expert Delphi process achieved consensus on 9 items related to exercise prescription to prevent amputee BMD loss. These will be implemented in a future randomised controlled trial. As sporting activity alone is insufficient to prevent hip demineralisation (3), these findings could also be implemented in athletes as part of their training programmes to prevent BMD loss. References https://doi.org/10.1002/jbmr.4794 https://doi.org/10.1002/jbmr.3284 https://doi.org/10.3389/fphys.2022.934622