Predicting walking capacity, walking performance, and life space mobility using socket comfort in lower-limb prosthesis users

ObjectiveTo determine if socket comfort predicts walking capacity, walking performance, and life-space mobility.DesignObservational exploratory study involving a secondary cross-sectional analysis using multiple regression of data collected from an exercise intervention trial.SettingLaboratory setting for clinical assessments; community setting for walking performance.ParticipantsCommunity-dwelling lower-limb prosthesis users over 50 years old (<i>n</i> = 72).Main measuresSocket Comfort Score, 2-Minute Walk Test, step count, Life Space Assessment, and control variables including demographics, Short Physical Performance Battery, Four Square Step Test, and Walking While Talking.ResultsRegression modeling showed Socket Comfort Score as a statistically significant predictor of 2-Minute Walk Test (<i>B</i> = 6.9 m, 95% CI [2.7, 11.1] m) alongside amputation level, Walking While Talking test, and Short Physical Performance Battery (greatest contribution to the model); the model accounted for 61% of the variance. Socket Comfort Score was not a statistically significant predictor of step count. Socket Comfort Score was the only statistically significant predictor of Life Space Assessment (<i>B</i> = 4.9, 95% CI [1.1, 8.8]); the model accounted for 12% of the variance.ConclusionsSocket comfort played a notable role in predicting walking capacity and life space mobility, but not in walking performance. Improving lower extremity function may have greater impact on walking overall. While this study provides context regarding socket comfort that clinicians may consider when planning holistic prosthetic rehabilitation, mixed findings in the literature suggest that further research on how socket comfort relates to walking outcomes in the community is warranted.