Clin Surg | Volume 6, Issue 1 | Research Article | Open Access

Correlation between BMD and Physical Activity Scores in Lower Limb Amputees

Rana Terlemez

Department of Physical Medicine and Rehabilitation, Saglik Bilimleri University, Sisli Hamidiye Etfal Education and Research Hospital, Turkey

*Correspondance to: Rana Terlemez 

Fulltext PDF


Background: Low bone mineral density is one of the common clinical problems in lower limb amputees that may lead to more serious complications. Objectives: We aimed to evaluate (i) the incidence of low Bone Mineral Density (BMD) in intact and amputated limbs, and (ii) the correlation between BMD and physical activity scores in lower limb amputees. Study Design: A cross-sectional and non-interventional trial was conducted in lower limb amputees in physical medicine and rehabilitation department of a university hospital. Methods: Forty-two unilateral lower limb amputees actively using prosthetics were enrolled. Dual Energy x-ray Absorptiometry (DXA) scanning was performed on all patients. Bone Mineral Density (BMD) for the lumbar spine (L1-L4) and bilateral femur (total hip, femoral neck) sites were assessed by using DXA (Lunar Prodigy Advance; GE, Madison, WI, USA). To evaluate the physical activity scores, Trinity Amputation and Prosthetic Experience Scales (TAPES) and Nottingham Extended Activities of Daily Living (NEADL) scales were used. Results: The rate of low BMD for the total hip and femoral neck on the amputated side were 80% and 83% respectively. The BMD values of the femur sites were found decreased on the amputated side with a statistically significant difference than the intact side (p<0.001). Femur Z scores of transfemoral amputees were significantly lower than transtibial amputees (p<0.05). There was no correlation between NEADL and TAPES Activity scores and BMD values. Conclusion: Lower limb amputation, particularly the transfemoral amputation was associated with loss of bone mineral density. It has been observed that the use of prosthesis and active lifestyle alone will not be enough to protect from osteoporosis.


Terlemez R. Correlation between BMD and Physical Activity Scores in Lower Limb Amputees. Clin Surg. 2021; 6: 3310.

Subscribe to Our Newsletter