Equilibrium and movement control strategies in transtibial amputees

Viton, Jean-Michel; Mouchnino, Laurence; Mille, Marie-Laure; Cincera, M; Delarque, A.; Pedotti, A.; Bardot, A; Massion, J

doi:10.1080/03093640008726533

Cited by 56 publications

(53 citation statements)

References 9 publications

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“…Their conclusion was that the required activity posed a very difficult task for most of the tested subjects. When standing on the prosthetic leg, the subjects need to maintain their balance solely by utilising hip and trunk strategies associated with double inverted pendulum models of stance where the centre of pressure excursions under the prosthetic foot are small due to the loss of the ankle joint (Viton et al, 2000). The important aspect of the results associated with the first outcome measure is that the majority of the subjects improved the duration of their standing after the treatment, which suggests that proper hip and trunk controlled balancing patterns were improved.…”

Section: Discussionmentioning

confidence: 99%

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

Matjačić

Burger

2003

Prosthetics &Amp; Orthotics International

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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.

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Section: Discussionmentioning

confidence: 99%

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

Matjačić

Burger

2003

Prosthetics &Amp; Orthotics International

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“…Afferent signals from proprioreceptors are reduced, which results in deterioration in balance 1 and limited function of selected muscles. 2 An amputee needs to adapt to their loss and learn new, or adjust to existing, movement patterns.…”

Section: Introductionmentioning

confidence: 99%

Variability of kinetic variables during gait in unilateral transtibial amputees

Svoboda

Janura

Cabell

et al. 2012

Prosthetics &Amp; Orthotics International

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Background: Prosthetic gait increases demands on stability. Some variability measures can be used to investigate the stability of movement for prosthetic feet.Objectives: The purpose of this study was to determine the influence of the prosthetic foot on ground reaction force variability for transtibial amputee gait.Study Design: Comparative analysis.Methods: Eleven male unilateral transtibial amputees participated in this study. Each subject walked at self-selected speed with both conventional (SACH) and energy storing (Sureflex) feet. Time and ground reaction force variables and their coefficients of variation were calculated for each foot type and limb.Results: Mediolateral force variables had high variability for all conditions. The Sureflex had a larger variability than the SACH foot for the braking peak ( p < 0.05), which may have been caused by gait instability after the heel strike. There were significant differences between intact and prosthetic limbs in total loading (force impulses) with the SACH foot ( p < 0.05).Conclusions: The prosthetic foot and alignment issues related to the foot influence GRF variability. During the braking phase the SACH foot is characterized by higher variability in mediolateral direction and Sureflex by higher variability in anterior-posterior direction.Clinical relevanceDifferences in variability in ground reaction force variables can represent a person’s stability. Observing variability can contribute to better understanding of critical events in gait cycle with the use of various prosthetic feet.

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“…However, APRs are influenced by many factors, including anxiety [30], previous experience [31], attention [32], and joint position [33]. In transtibial prosthesis users, APRs differ from previous investigations involving muscular response [20][21][34][35] in that they do not allow preemptive postural adjustments in anticipation of a motor task, but are mediated by feedback mechanisms and not under volitional control [36][37]. Support-surface rotations (SSRs) have been used to investigate APRs in young nondisabled participants [29][30][38][39], as well as in older individuals [26] and those with total knee arthroplasty [40].…”

Section: Introductionmentioning

confidence: 98%

“…Studies of individuals with lower-limb amputation have linked falling with movement of the CoP in the anteroposterior direction [8] and in individuals without amputation with a movement of the CoP in mediolateral plane [17][18][19]. Other researchers have investigated CoP and muscular response to catching a falling object [20] or lifting a leg [21]. In addition to increased CoP excursion, these studies have demonstrated that prosthesis users have an alteration in automatic muscular responses compared with nondisabled individuals.…”

Section: Introductionmentioning

confidence: 99%

Bilateral electromyogram response latency following platform perturbation in unilateral transtibial prosthesis users: Influence of weight distribution and limb position

Rusaw

Hagberg²,

Nolan³

et al. 2013

JRRD

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Abstract-Appropriate muscular response following an external perturbation is essential in preventing falls. Transtibial prosthesis users lack a foot-ankle complex and associated sensorimotor structures on the side with the prosthesis. The effect of this lack on rapid responses of the lower limb to external surface perturbations is unknown. The aim of the present study was to compare electromyogram (EMG) response latencies of otherwise healthy, unilateral, transtibial prosthesis users (n = 23, mean +/-standard deviation [SD] age = 48 +/-14 yr) and a matched control group (n = 23, mean +/-SD age = 48 +/-13 yr) following sudden support-surface rotations in the pitch plane (toes-up and toes-down). Perturbations were elicited in various weight-bearing and limb-perturbed conditions. The results indicated that transtibial prosthesis users have delayed responses of multiple muscles of the lower limb following perturbation, both in the intact and residual limbs. Weight-bearing had no influence on the response latency in the residual limb, but did on the intact limb. Which limb received the perturbation was found to influence the muscular response, with the intact limb showing a significantly delayed response when the perturbation was received only on the side with a prosthesis. These delayed responses may represent an increased risk of falling for individuals who use transtibial prostheses.

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Equilibrium and movement control strategies in transtibial amputees

Cited by 56 publications

References 9 publications

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

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

Variability of kinetic variables during gait in unilateral transtibial amputees

Bilateral electromyogram response latency following platform perturbation in unilateral transtibial prosthesis users: Influence of weight distribution and limb position

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