Global Positioning Satellite and step-activity monitor devices are being used in a ground breaking study aimed at tracking the movements of lower-limb amputees to see if they have successfully reintegrated into the community following amputation.
The Repatriation General Hospital study in Adelaide, South Australia, which is being undertaken by Rehabilitation and Aged Care researchers, is assessing the community activity and participation of 47 patients, who have been fitted with prosthesis in the past six months.
Researcher Dr Chris Barr, who has undertaken the study with PhD student Brenton Hordacre, said only a small number of patients — between 26 and 62 percent — achieved outdoor mobility following amputation, limiting their ability for community involvement.
“There are many reasons why people limit their outdoor activities, and this has a huge knock-on effect for aspects such as health and social inclusion,” Dr Barr said.
“For clinicians and researchers, assessment of community activity and participation following rehabilitation is a key marker of successful prosthetic rehabilitation. Prosthetic mobility has been associated with quality of life, greater involvement in social activities and day-to-day living, as well as participation in employment and recreation.”
Dr Barr said the GPS device and stepactivity monitor (SAM) were strapped onto the patients’ prosthetic legs and worn for seven consecutive days.
“The SAM uses accelerometers to recognize when a step is taken and logs a count of the number of steps taken, while the data from the GPS device can be put into software that uses Google maps, so we could categorize locations,” he said.
“A step counter alone will tell us how active someone is, but we don’t know if they limit this to their home and other safe locations. A GPS device tells us where people go, but not if they are active in these locations. This study measures both of these outcomes, and links the two, giving us an objective measure of activity and participation.”
He said the next stage of the research would measure the data collected by the devices against information collected in a clinical setting such as gait and falls history.
“There are a lot of measures, such as time walking tests that are used clinically to predict community activity and involvement in different patient groups. These tend to rely on comparisons with activity diaries and self-reporting from the participants to assess their relationship with community activity. The clinical tests are usually done in a safe, flat, indoor environment and may not be representative of real life activities. In patient groups who are at a higher risk of falling, such as amputees, we are unsure if what they demonstrate they are able to do in the clinic translates to real life activities, so we wanted to have an objective measure of activity in the community.”
Researchers are planning to trial this technology with other groups where social isolation is a risk, including older people who have been referred to the Repat’s Falls Clinic.