Physical activity levels are low in the days, weeks, and months following dysvascular major lower limb amputation

OBJECTIVE: To determine physical activity levels and their associated factors post-dysvascular major lower limb amputation. DESIGN: Multicentre longitudinal observational study. SUBJECTS: Eighty-one adults with dysvascular major lower limb amputation. METHOD: Physical activity was assessed via questionnaire (adapted-SQUASH: total min, moderate/vigorous min, MET-min/week), self-reported adherence to Dutch physical activity guidelines, and accelerometer (Activ8: min, bouts, fragmentation) at < 12 days, 5 weeks, 6 months, and 9 months post-amputation. Associated factors were assessed using mixed model analysis. RESULTS: Median [interquartile range] questionnaire-assessed activity increased: 240 [90;600], 525 [245;880], 678 [334;1176], and 885 [525;1733] min/week (p = 0.004). Dutch guideline adherence was 16%, 55%, 47%, and 27%, respectively. Accelerometer-derived activity was 5 [5;9], 26 [13;50], 50 [33;64], and 54 [44;67] min/day. Number of active bouts ranged from 0.0 [0.0;0.0] to 2.0 [1.0;3.0] per day, with fragmentation between 0.0 [0.0;0.0] and 0.4 [0.4;0.5]. Questionnaire-assessed physical activity was negatively associated with age (β = -16 min/week, p = 0.009) and undernutrition (β = -270 min/week, p = 0.013), and positively with grip strength (β = 14 min/week, p = 0.014). CONCLUSION: Physical activity levels increase but remain low post-lower limb amputation. Age, undernutrition, and grip strength are associated with physical activity. These findings underscore the need for targeted physical activity interventions for individuals post-amputation, to optimize health and clinical outcomes.