MAAT VII: Normative Mobility Values for Lower Limb Prosthesis Users of Varying Age, Etiology, and Amputation Level


American Journal of Physical Medicine & Rehabilitation
Read Online
Download Now


Dwiesha L. England, MSEng1, Taavy A. Miller, PhD1,2, Phillip M. Stevens, MEd1,3, James H. Campbell, PhD1, Shane R. Wurdeman, PhD1,4

  1. Department of Clinical and Scientific Affairs, Hanger Clinic, Austin, TX
  2. Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC
  3. School of Medicine, University of Utah, Salt Lake City, UT
  4. Department of Biomechanics, University of Nebraska at Omaha, Omaha, NE


As the seventh and final study in the Mobility Analysis of Amputees (MAAT) series, MAAT VII: Normative Mobility Values for Lower Limb Prosthesis Users of Varying Age, Etiology, and Amputation Level analyzed data from nearly 12,000 lower limb prosthesis users, who were grouped by age, amputation etiology, and above vs. below-knee amputation. MAAT VII established normative values for each group, ultimately expanding known benchmarks from two etiologies across four age groups, to four etiologies (cancer, congenital, trauma, and diabetes/dysvascular) across seven age groups. The awareness of differences across amputation etiologies extending across the lifespan of ages can assist the goal-setting process as part of prosthetic rehabilitation. Additionally, refined normative values provide the ability to benchmark new and innovative changes in clinical practice.

The MAAT series, which has been published regularly by the Hanger Institute for Clinical Research and Education since 2017, represents the largest national analyses of mobility among lower limb prosthetic users and clarifies the concept of prosthetic mobility as it relates to considerations such as satisfaction, quality of life, comorbid health conditions, and prosthetic component choices.


The objective of this study was to establish normative values for individuals with lower limb difference/amputation due to cancer or congenital etiologies, and expand those available for etiologies associated with trauma and diabetes/dysvascular.


A retrospective cross-sectional observational analysis was performed on mobility outcomes completed in the United States.

Patient Inclusion Criteria:

Table 1: Patient Demographics (n=11,995)


Older individuals with above-knee or below-knee amputations reported reduced mobility across the four primary etiologies. As expected, the oldest age group had the lowest mobility across amputation level and etiology. The diabetes/dysvascular etiology had the lowest median mobility scores across amputation levels and was significantly different from trauma, cancer, and congenital disease.

Figure 1

Changes in Mobility with Age

The optimal best fit line across age group medians was plotted for cancer, congenital, trauma, and diabetic/dysvascular etiologies for both individuals with above-the-knee and below-the-knee amputation. Diabetes/dysvascular shows the greatest decline with age.


Meet the MAAT VII Authors

Latest Updates

Subscribe to stay up-to-date on our latest posts.

View All