Falls perceived as significant by lower limb prosthesis users are generally associated with fall consequences rather than circumstances

PurposeTo determine if falls perceived as significant by lower limb prosthesis (LLP) users were associated with fall circumstances and/or consequences.Materials and methodsThe circumstances and consequences of LLP users' most significant fall in the past 12-months were collected using the Lower Limb Prosthesis User Fall Event Survey. Participants rated fall significance from 0 (not significant) to 10 (extremely significant), which was then dichotomized into "low" and "high". Binary logistic regression was used to assess associations between fall significance and fall circumstances and consequences.ResultsNinety-eight participants were included in the analysis. Five fall consequences were associated with greater significance: major injury (OR = 26.7, 95% CI: 1.6-459.6, p = 0.024), need to seek medical treatment (OR = 19.0, 95% CI: 1.1-329.8, p = 0.043), or allied-health treatment (OR = 18.2, 95% CI: 2.3-142.4, p = 0.006), decreased balance confidence (OR = 10.9, 95% CI: 2.4-49.3, p = 0.002), and increased fear of falling (OR = 7.5, 95% CI: 2.4-23.8, p = 0.001), compared to two fall circumstances: impact to the arm (OR = 5.0, 95% CI: 2.0-12.1, p = 0.001), and impact to the face, head, or neck (OR = 9.7, 95% CI: 1.2-77.4, p = 0.032).ConclusionsSignificant falls were generally more associated with fall consequence than fall circumstances. Falls remain common, injurious, costly, and socially isolating events for lower limb prosthesis (LLP) users.Falls perceived as most significant by LLP users were associated with injury, reduced balance confidence, and increased fear-of-falling.Studying falls perceived by LLP users as significant may help reduce falls that matter most to LLP users.