The association between cognitive function and physical performance in established users of a lower limb prosthesis.

Background: Cognitive abilities are important for mobility functions in individuals with amputation.

Aims: To investigate the association between cognitive function and physical performance in established users of a lower limb prosthesis.

Methods: This prospective cross-sectional study was included established users of a lower limb prosthesis (N = 62; mean age ± SD, 41.33 ± 14.76 years). The Montreal Cognitive Assessment was used to evaluate cognitive function. The Timed Up and Go Test under single-task and dual-task conditions, the Four Square Step Test, and the 3-m Backward Walk Test were used for physical performance assessment.

Results: An independent association was found of the Montreal Cognitive Assessment to the dual task Timed Up and Go Test (AdjR² = 0.168, p = 0.003), the Four Square Step Test (AdjR² = 0.25, p = 0.003) and the 3-m Backward Walk Test (AdjR² = 0.159, p = 0.032). An increase of 1 point in the Montreal Cognitive Assessment was associated with a reduction of 0.681 s (95% CI, 1.116-0.246) in the the dual task Timed Up and Go Test, 0.378 s (95% CI, 0.617-0.138) in the Four Square Step Test, and 0.255 s (95% CI, 0.487-0.022) in the 3-m Backward Walk Test.

Conclusions: The results of this study revealed an independent association between global cognitive function and functional mobility under dual-task conditions, dynamic balance, and backward walking performance in established users of a lower limb prosthesis. These results emphasize that cognitive functions should be taken into account in interventions aimed at improving challenging physical performance in established users of a lower limb prosthesis.