Factors associated with committed participation in a wellness-walking program for people with lower limb loss: A prospective cohort study.

Abstract

Wellness activities can benefit health, yet committed adherence is challenging. Identify factors associated with committed participation in an amputee wellness-walking program and determine benefits of committed participation. Prospective longitudinal cohort. Two former Paralympians led the wellness-walking sessions. Participants provided medical history and self-reported balance confidence and prosthetic functional measures. Physiotherapy professionals/paraprofessionals assessed balance and gait. Committed participants-those attending three sessions within 3 years-were compared to one-time-only participants using Fisher's exact and independent t-tests. First and third sessions for committed participants were compared with t-tests. A bootstrapped multivariable logistic regression model was developed using significant univariate predictors. A total of 305 volunteers averaged 55.7 ± 15.2 years, including 68.4% men, 78.4% White race; 51.8% with dysvascular amputations, 40.5% with ⩾1 prosthetic knee; and 49.1% independent community walkers. Committed participants were initially similar to one-time-only participants ( p > 0.05) except for fewer years since amputation ( p = 0.007), better balance ability ( p = 0.001), and greater likelihood of dieting ( p = 0.030). The final model-balance ability (odds ratio = 2.4), dieting (odds ratio = 3.3), and years since amputation (odds ratio = 0.94)-identified 88.0% of committed participants ( p = 0.007). Balance confidence and functional improvements after three sessions were not significant ( p > 0.07). Committed participants were more likely to diet, have better balance ability, and have more recent amputations than one-time-only participants. Knowing which characteristics identify people most likely to become committed participants-such as people with recent amputations, an interest in dieting, and better balance ability-may help health practitioners from different professions promote consistent participation in wellness activities that may benefit self-reported function.