Dynamic balance training during standing in people with trans-tibial amputation

Abstract

Falls and fear of falling are significant problems arising from impaired balancing abilities that affect people with lower limb amputation during unassisted transfer manoeuvres and ambulation. It is important to develop and evaluate efficient therapeutic interventions aimed at improving balancing and coordination skills. A group of 14 persons after trans-tibial amputation, fitted with trans-tibial prostheses, were included in a balance-training programme, consisting of approximately 20 minutes of balance training per day for five consecutive days on BalanceReTrainer -a novel balance-training, fall-safe mechanical apparatus. Before and after the training period three outcome measures were taken: duration of standing only on the prosthetic leg, timed up and go test and 10m walk. Each measurement was repeated five times and the mean value was used in the subsequent calculation of mean values and standard deviations for the group. Before training the group was able to stand on the prosthetic leg for 2.98 ± 2.75s, they needed 6.15 ± 1.9s for accomplishing timed up and go test and they needed 5.51 ± 1.5s to cover the distance of 10m. After the treatment period the values were 4.3 ± 4.5s, 5.4 ± 1.5s and 4.5 ± 0.9s, respectively. The results indicate improved performance in all three measured tasks, thereby indicating that the applied treatment programme improves balancing and ambulation abilities in people after trans-tibial amputation.

Quantitative Assessment of Postural Stability and Balance Between Persons with Lower Limb Amputation and Normal Subjects by using Dynamic Posturography

“…Falls and fear of falling are significant problems arising from impaired balancing abilities that affect people with lower limb amputation during unassisted transfer maneuvers and ambulation [2,9].Therefore, it seems important to study balance among people with amputations. Computariesed dynamic posturography (CDP) has become an important tool for understanding standing balance in clinical settings among persons with amputations.…”

“…Moreover, fall and fear of falling are significant problems arising from impaired balancing abilities that affect people with lower limb amputation during unassisted transfer maneuvers and ambulation [2]. Other studies suggest that the balance and postural control strategy of persons with amputation relating to the gait initiation process is not a fixed motor program, but also, person with amputation will require time and training to develop alternative neuromuscular control and coordination strategies [11].…”

“…Falls and fear of falling are significant problems arising from impaired balancing abilities that affect people with lower limb amputation during unassisted transfer maneuvers and ambulation [2] .…”

Role of balance ability and confidence in prosthetic use for mobility of people with lower-limb loss

“…Prosthetic componentry and functional gait training have both been shown to improve gait performance ability, as measured by outcomes such as the twominute walk test [11][12]. However, development of balance ability alone has also been shown to improve gait performance measured with the Timed "Up and Go" test [13]. In addition, the psychological awareness of the movement patterns required for functional gait has been shown to affect prosthetic gait function [14].…”

Comparison of 6-minute walk test performance between male Active Duty soldiers and servicemembers with and without traumatic lower-limb loss

“…The need to assess fitness, mobility, and function in people with lower-limb loss has required the use of a number of different outcome measures in this population. These measures include many that are typically used in the elderly civilian population with and without limb loss, including the Timed Up and Go, Ltest, 2-minute walk test, 6-minute walk test (6MWT), and Amputee Mobility Predictor [4][5][6][7][8][9][10][11][12][13][14][15][16][17]. Many of these measures have also been assessed in a relatively healthy younger population with or without lower-limb loss.…”