Assessing mobility for persons with lower limb amputation: the Figure-of-Eight Walk Test with the inclusion of two novel conditions

Schack, Jette; Mirtaheri, Peyman; Steen, Harald; Gjøvaag, Terje

doi:10.1080/09638288.2019.1662495

Cited by 20 publications

(33 citation statements)

References 56 publications

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“…Eight studies compared PLLA and CN, 28,31,46,49,51,52,54,55 four were within PLLA, 24,25,30,53 and seven assessed microprocessor vs non‐microprocessor prostheses 43‐45,47,48,50,55 . One study on the use of microprocessor prostheses made comparisons to both CN and PLLA using a non‐microprocessor prosthesis 55 .…”

Section: Resultsmentioning

confidence: 99%

The effect of dual‐task testing on the balance and gait of people with lower limb amputations: A systematic review

Omaña

Madou

Montero‐Odasso

et al. 2021

PM&R

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Objective: To systematically review the literature on the effect of dual-task testing on the balance and gait of people with lower limb amputations (PLLA). Literature Survey: Databases MEDLINE, EMBASE, CINAHL, PsycINFO, Web of Science, and Scopus were searched in duplicate (inception to December 1, 2020). Methodology: Inclusion criteria: participants were adults with transtibial, kneedisarticulation, transfemoral, or bilateral lower limb amputations; balance or gait was paired with a secondary task; and studies were peer-reviewed and published in English. Two authors independently reviewed articles and consensus was required. A standardized data extraction sheet was used to gather study relevant information in duplicate. Methodological quality of reporting was examined using the Downs and Black Scale. A meta-analysis was unable to be performed owing to substantial participant and protocol heterogeneity among the studies included. Synthesis: Of 3950 articles screened, 22 met inclusion criteria. Four assessed dual-task balance and 18 dual-task gait. During single-task standing, PLLA demonstrated higher sway distance and sway velocity than controls (CN); however, a greater dual-task effect was observed only for sway velocity. Gait pace, rhythm, variability, asymmetry, and postural control were observed to be worse in PLLA relative to CN during single-task. Dual-task gait testing resulted in a disproportionally reduced pace and rhythm and increased asymmetry in PLLA compared to CN. Conclusions: People with lower limb amputations have impaired balance and gait, which is affected by dual-task to a greater degree compared to healthy adults. An examination of how PLLA-specific factors such as level of amputation, reason for amputation, and experience with a prosthesis affect dual-task performance has not yet been thoroughly explored. Future research should continue to characterize the cognitive-mobility link to better understand the challenges associated with the use of a prosthesis.

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Section: Resultsmentioning

confidence: 99%

The effect of dual‐task testing on the balance and gait of people with lower limb amputations: A systematic review

Omaña

Madou

Montero‐Odasso

et al. 2021

PM&R

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“…Future research could explore, the use of attractors within the context of the FO8WT, but with focus placed upon how a patient moves, along with how they approach each aspect of the FO8WT (e.g., clockwise and anti-clockwise turns). This is particularly important as both curved, and straight walking are utilized in everyday walking (Schack et al, 2019), and require patients to use different muscles (Hess et al, 2010;Wong et al, 2013). This may interlink with research that considers patient confidence regarding their own motor capability, which is argued to interlink with patient motivation and continued recovery (Morris et al, 2017), and whether this may then impact how therapists target different patients motor (re)learning.…”

Section: Discussionmentioning

confidence: 99%

“…During everyday functional tasks, both curved and straight walking are utilized to navigate around obstacles in an environment (Schack et al, 2019). A widely-used walking intervention which assesses both straight and curved path walking is the "figure of eight walk test" (FO8WT) (Hess et al, 2010;Wong et al, 2013;Welch et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

The Use of Embedded Context-Sensitive Attractors for Clinical Walking Test Guidance in Virtual Reality

Croucher¹,

Powell²,

Dicks³

et al. 2021

Front. Virtual Real.

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Virtual reality is increasingly used in rehabilitation and can provide additional motivation when working toward therapeutic goals. However, a particular problem for patients regards their ability to plan routes in unfamiliar environments. Therefore, the aim of this study was to explore how visual cues, namely embedded context-sensitive attractors, can guide attention and walking direction in VR, for clinical walking interventions. This study was designed using a butterfly as the embedded context-sensitive attractor, to guide participant locomotion around the clinical figure of eight walk test, to limit the use of verbal instructions. We investigated the effect of varying the number of attractors for figure of eight path following, and whether there are any negative impacts on perceived autonomy or workload. A total of 24 participants took part in the study and completed six attractor conditions in a counterbalanced order. They also experienced a control VE (no attractors) at the beginning and end of the protocol. Each VE condition lasted a duration of 1 min and manipulated the number of attractors to either singular or multiple alongside, the placement of turning markers (virtual trees) used to represent the cones used in clinical settings for the figure of eight walk test. Results suggested that embedded context-sensitive attractors can be used to guide walking direction, following a figure of eight in VR without impacting perceived autonomy, and workload. However, there appears to be a saturation point, with regards to effectiveness of attractors. Too few objects in a VE may reduce feelings of intrinsic motivation, and too many objects in a VE may reduce the effectiveness of attractors for guiding individuals along a figure of eight path. We conclude by indicating future research directions, for attractors and their use as a guide for walking direction.

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“…comfort, stability, muscle fatigue) can be difficult to quantify with certainty. As a result of these challenges, researchers tend to motivate and validate their new devices with a narrow set of metrics; criteria that have been used include muscle activation [17][18][19], joint work [20,21], limb power [22], self-selected walking speed [23,24], peak moments [25,26], range of motion [27,28], kinematic symmetry [29,30], metabolic cost [22,[31][32][33], and extensive patientreported surveys [34][35][36][37]. Furthermore, these factors may provide competing indications of "optimal" device behavior.…”

Section: Introductionmentioning

confidence: 99%

Understanding patient preference in prosthetic ankle stiffness

Clites

Shepherd

Ingraham

et al. 2021

J NeuroEngineering Rehabil

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Background User preference has the potential to facilitate the design, control, and prescription of prostheses, but we do not yet understand which physiological factors drive preference, or if preference is associated with clinical benefits. Methods Subjects with unilateral below-knee amputation walked on a custom variable-stiffness prosthetic ankle and manipulated a dial to determine their preferred prosthetic ankle stiffness at three walking speeds. We evaluated anthropomorphic, metabolic, biomechanical, and performance-based descriptors at stiffness levels surrounding each subject’s preferred stiffness. Results Subjects preferred lower stiffness values at their self-selected treadmill walking speed, and elected to walk faster overground with ankle stiffness at or above their preferred stiffness. Preferred stiffness maximized the kinematic symmetry between prosthetic and unaffected joints, but was not significantly correlated with body mass or metabolic rate. Conclusion These results imply that some physiological factors are weighted more heavily when determining preferred stiffness, and that preference may be associated with clinically relevant improvements in gait.

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Assessing mobility for persons with lower limb amputation: the Figure-of-Eight Walk Test with the inclusion of two novel conditions

Cited by 20 publications

References 56 publications

The effect of dual‐task testing on the balance and gait of people with lower limb amputations: A systematic review

The effect of dual‐task testing on the balance and gait of people with lower limb amputations: A systematic review

The Use of Embedded Context-Sensitive Attractors for Clinical Walking Test Guidance in Virtual Reality

Understanding patient preference in prosthetic ankle stiffness

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