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

Omaña, Humberto; Madou, Edward; Montero‐Odasso, Manuel; Payne, Michael; Viana, Ricardo; Hunter, Susan

doi:10.1002/pmrj.12702

Cited by 8 publications

(6 citation statements)

References 67 publications

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“…A conceivable approach to account for the brain’s influence is through dual tasks, conditional on adequate familiarisation [ 95 ]. Dual tasks involve the concurrent performance of two tasks and are regarded as a measurement of cognitive-motor capacity as they require executive function and attentional demand [ 95 ]. Their performance usually results in decreased mobility and deteriorated gait patterns leading to increment falls [ 96 , 97 ].…”

Section: Discussionmentioning

confidence: 99%

“…Lack of familiarization time to habituate to the new prosthetic device may have influenced these results. As discussed earlier, the negative implications of performing dual-tasks are attributable to cognitive demands associated with prosthetic use, balance and gait disturbances, and brain adaptations [ 9 , 10 , 27 , 95 ]. Combined with the fact that dual-tasks represent daily activities, the recommendation is to include dual-task paradigms in the evaluation process of prostheses [ 95 ].…”

Section: Discussionmentioning

confidence: 99%

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Therapeutic benefits of lower limb prostheses: a systematic review

Lathouwers

Díaz

Maricot

et al. 2023

J NeuroEngineering Rehabil

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Background Enhancing the quality of life of people with a lower limb amputation is critical in prosthetic development and rehabilitation. Yet, no overview is available concerning the impact of passive, quasi-passive and active ankle–foot prostheses on quality of life. Objective To systematically review the therapeutic benefits of performing daily activities with passive, quasi-passive and active ankle–foot prostheses in people with a lower limb amputation. Methods We searched the Pubmed, Web of Science, Scopus and Pedro databases, and backward citations until November 3, 2021. Only English-written randomised controlled trials, cross-sectional, cross-over and cohort studies were included when the population comprised individuals with a unilateral transfemoral or transtibial amputation, wearing passive, quasi-passive or active ankle–foot prostheses. The intervention and outcome measures had to include any aspect of quality of life assessed while performing daily activities. We synthesised the participants’ characteristics, type of prosthesis, intervention, outcome and main results, and conducted risk of bias assessment using the Cochrane risk of bias tool. This study is registered on PROSPERO, number CRD42021290189. Results We identified 4281 records and included 34 studies in total. Results indicate that quasi-passive and active prostheses are favoured over passive prostheses based on biomechanical, physiological, performance and subjective measures in the short-term. All studies had a moderate or high risk of bias. Conclusion Compared to passive ankle–foot prostheses, quasi-passive and active prostheses significantly enhance the quality of life. Future research should investigate the long-term therapeutic benefits of prosthetics devices.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Therapeutic benefits of lower limb prostheses: a systematic review

Lathouwers

Díaz

Maricot

et al. 2023

J NeuroEngineering Rehabil

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“…Recent evidence has shown that PLLA perform worse on gait pace, rhythm, and variability domains during walking tasks that require dual tasking. 53 Ambulating in daily life often requires the need to perform such dual-task scenarios while walking, placing increased demands on the cognitive resources available, and subsequently decreasing gait performance. 53 The addition of dual-task training to a multicomponent exercise program may, therefore, provide benefits to coordination ability during gait required for daily life, 54 which may assist in reducing gait asymmetries.…”

Section: Discussionmentioning

confidence: 99%

“…53 Ambulating in daily life often requires the need to perform such dual-task scenarios while walking, placing increased demands on the cognitive resources available, and subsequently decreasing gait performance. 53 The addition of dual-task training to a multicomponent exercise program may, therefore, provide benefits to coordination ability during gait required for daily life, 54 which may assist in reducing gait asymmetries. In addition, advances in technology have allowed for the introduction of interventions such as VR training.…”

Section: Discussionmentioning

confidence: 99%

The effect of exercise interventions on gait outcomes in subacute and chronic rehabilitation from lower-limb amputation: A systematic review and meta-analysis

Madou,

Sureshkumar,

Payne

et al. 2023

Prosthetics &Amp; Orthotics International

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Successful walking is a substantial contributor to quality of life in people with lower-limb amputation (PLLA), yet gait difficulties are common. Evidence-based exercise guidelines are necessary for PLLA with different clinical characteristics and at different phases of recovery. To systematically review the literature evaluating effects of exercise interventions on gait outcomes in PLLA at subacute and chronic stages of recovery. Databases MEDLINE, EMBASE, CINAHL, SPORTDiscus, Scopus, and the Cochrane Library were searched (inception to May 10, 2022). Inclusion criteria: randomized controlled trials assessing gait outcomes following exercise intervention; subjects were PLLA ≥18 years of age and used a prosthesis for walking. Meta-analysis using random effects with inverse variance to generate standardized mean differences (SMDs) was completed for primary gait outcomes. Subgroup analysis was conducted for the recovery phase (i.e., subacute and chronic) and level of amputation (e.g., transfemoral and transtibial). Of 16 included articles, 4 studies examined the subacute phase of recovery, whereas 12 examined the chronic phase. Subacute interventions were 30 minutes, 1–7 times/week, for 2–12 weeks. Chronic interventions were 15–60-minutes, 2–3 times/week, for 4–16 weeks. Low–moderate level evidence was shown for a small improvement in the subacute phase (SMD = 0.42, 95% confidence interval [0.06–0.79], I2 = 46.0%) and a moderate improvement in the chronic phase (SMD = 0.67, 95% confidence interval [0.40–0.94], I2 = 0.0%) in favor of exercise intervention groups. Multicomponent exercise programs consisting of gait, balance, and strength training are effective at improving gait outcomes in PLLA at subacute and chronic phases of recovery. The optimal duration and frequency of exercise is unclear because of variation between interventions, highlighting an area for future work.

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“…Hence, the importance of developing methods allows for objectifying the choice of the optimal level of amputation with the aim of maximally reducing this level without increasing the risk of early purulent-necrotic postoperative complications is understood [3,4]. These complications are the result of excessively «economical» amputation, when the line of excision of the limb falls on tissues with impaired tissue metabolism and insufficient oxygenation, therefore, it is important to develop diagnostic methods which would help determine the «ideal» level of amputation [5,6].…”

Section: Introductionmentioning

confidence: 99%

Level Selection of Non-Traumatic Lower Extremity Amputations in Patients With Critical Ischemia

Vasyliuk

Osadets

Prudnikov

et al. 2022

Modern Medical Technology

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Objective. To evaluate the informativeness of ultrasound scanning of the lower limb arteries and angiography in patients with critical ischemia for choosing the optimal level of extremity amputation. Methods. Treatment of 289 patients with obliterative diseases of the arteries of the lower extremities of various genesis with the indications for amputation of the damaged lower extremity was analyzed. Results. Ultrasound scanning of arteries could not always characterize the severity of collateral circulation, but indicated only the level of occlusion. However, the severity of chronic ischemia of the lower limb is determined not only by the level of occlusion, but also by the severity of collateral blood flow at the same level of damage. That is why, in our opinion, the results of an ultrasound examination of the lower limb arteries cannot be decisive when choosing the level of amputation. Angiography made it possible to characterize not only the level of occlusion or stenosis, but also the state of collateral circulation, which had a decisive influence on the choice of the method of limb amputation. Conclusion. Ultrasound examination of the lower extremity vessels allows to establish the level of occlusion, but is uninformative for the assessment of collateral anastomoses, which is an important factor in choosing the level of non-traumatic amputation of the lower extremity. In patients with critical ischemia, transtibial amputations should be avoided, as they show worse results. The operation of choice should be a transfemoral amputation or non-traumatic through-knee amputation.

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

Cited by 8 publications

References 67 publications

Therapeutic benefits of lower limb prostheses: a systematic review

Therapeutic benefits of lower limb prostheses: a systematic review

The effect of exercise interventions on gait outcomes in subacute and chronic rehabilitation from lower-limb amputation: A systematic review and meta-analysis

Level Selection of Non-Traumatic Lower Extremity Amputations in Patients With Critical Ischemia

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