Impact of social distancing measures on step activity in individuals with lower-limb amputation during the COVID-19 pandemic

The COVID-19 pandemic significantly affected global health and physical activities, necessitating social distancing measures (SDM) to control viral spread. This study investigated the impact of the SDM on the step activity of individuals with transtibial or transfemoral amputation in Hong Kong. Sixteen individuals with unilateral lower-limb amputation (5 transtibial, 11 transfemoral) participated in this study. Participants wore a StepWatch Activity Monitor to continuously record their step activity once during the SDM period and once after the SDM period over 28 days. Daily and hourly step counts, as well as walking bout frequency, were analyzed to compare physical activities between the two periods. Although group-level means showed no statistically significant differences for most parameters, individual-level analyses with statistical parametric mapping revealed significant within-participant changes in hourly step counts and walking bout frequency. In particular, significant changes in hourly step counts were observed during typical morning and evening commutes as well as lunch breaks. Additionally, the frequency of 12-step walking bouts significantly increased after SDM ended. These findings suggest that altered walking habits, commuting, and indoor activities may have shaped step patterns during and after SDM, providing insight into how SDM during the COVID-19 pandemic influenced walking behaviors in individuals with lower-limb amputation.