ORIGINAL ARTICLE Climbing Stairs After Outpatient Rehabilitation for a Lower-Limb Amputation Fred A. de Laat, MD, a,b,c Gerardus M. Rommers, MD, PhD, c Pieter U. Dijkstra, MD, PT, PhD, c Jan H. Geertzen, MD, PhD, c Leo D. Roorda, MD, PT, PhD d From the a Rehabilitation Center Leijpark, Libra Zorggroep, Tilburg; b Rehabilitation Center Tolbrug, Jeroen Bosch Hospital, ’s Hertogenbosch; c Department of Rehabilitation Medicine, University Medical Center of Groningen, Groningen; and d Amsterdam Rehabilitation Research Cente, Reade, Amsterdam, The Netherlands. Abstract Objective: To study the necessity and ability to climb stairs in persons after a lower-limb amputation (LLA) and the relation of this ability with personal and clinical variables. Design: Cross-sectional study. Setting: Outpatient department of a rehabilitation center. Participants: Persons with an LLA (NZ155; mean age  SD, 64.111.2y; 73% men). Interventions: Not applicable. Main Outcome Measures: The necessity to climb stairs was assessed with the Prosthetic Profile of the Amputee. Several indicators of the ability to climb stairs were assessed including: (1) independence in climbing stairs with a handrail and (2) without a handrail, according to the Locomotor Capabilities Index; (3) numbers of floors actually climbed, according to a rating scale; and (4) limitations in climbing stairs, according to the Climbing Stairs Questionnaire (range, 0e100, with higher scores indicating less limitations). Multivariate logistic regression analysis was used to investigate the associations between the ability to climb stairs and personal and clinical variables. Results: Of the participants, 47% had to climb stairs. The ability to climb stairs was: (1) 62% independently climbed stairs with a handrail and (2) 21% without a handrail; (3) 32% didn’t climb any stairs, 34% climbed half a floor or 1 floor, and 34% climbed 2 floors; (4) the median sum score (interquartile range) of the Climbing Stairs Questionnaire was 38 (19e63), indicating marked limitations. Older participants and women were less able to climb stairs with and without a handrail. Conclusions: A considerable number of persons with an LLA have to climb stairs in their home environment. Many of them, especially older participants and women, are particularly hampered in their ability to climb stairs. Archives of Physical Medicine and Rehabilitation 2013;94:1573-9 ª 2013 by the American Congress of Rehabilitation Medicine Persons with a lower-limb amputation (LLA) report that climbing stairs is an important issue, 1 but this issue has not yet been studied in great detail. 2 Furthermore, climbing stairs has only been investigated in persons with an LLA as a superficial, secondary outcome. 3-5 Based on these studies, between 42% and 80% of persons with an LLA are able to climb stairs independently. In daily clinical practice, climbing stairs in persons with an LLA could be very important. This is particularly the case if there is a necessity for the person to climb stairs within, or in order to, enter their house. However, even if this is not the case, climbing stairs may still be of great importance in order to access other places, which have not been adapted for the mobility-impaired person. Important aspects of the ability to climb stairs are safety, inde- pendence during stair climbing, the number of flights of stairs the person can negotiate, and whether limitations are perceived. If a person lives alone and is not able to climb stairs independently, or is only able to climb a small number of steps, the home environment would need to be adapted, the person would need to move to another house, or they would need admission to a long-stay care facility. Generally, if a person does not perceive any limitations, they would not seek help within the health care system. There are many factors that may influence the ability of persons with an LLA to climb stairs. When amputation is caused by vascular No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated. 0003-9993/13/$36 - see front matter ª 2013 by the American Congress of Rehabilitation Medicine http://dx.doi.org/10.1016/j.apmr.2013.01.020 Archives of Physical Medicine and Rehabilitation journal homepage: www.archives-pmr.org Archives of Physical Medicine and Rehabilitation 2013;94:1573-9