Postural Sway in Lower Extremity Amputees and Older Adults May Suggest Increased Fall Risk in Amputees

Abstract

BACKGROUND: Falls can be detrimental to overall health and quality of life for lower extremity amputees. Most previous studies of postural steadiness focus on quantification of time series variables extracted from postural sway signals. While it has been suggested that frequency domain variables can provide more valuable information, few current studies have evaluated postural sway in amputees using frequency domain variables.
 OBJECTIVE: To determine time and frequency domain variables of postural sway among lower extremity amputees vs. healthy young and older adult controls.
 METHODOLOGY: Participants were assigned to 3 groups: lower extremity amputation (n=6), healthy young adults (n=10), and healthy older adults (n=10). Standing barefoot on a force platform, each individual completed 3 trials of each of 3 standing conditions: eyes open, eyes closed, and standing on a foam balance pad. Time and frequency domain variables of postural sway were computed and analyzed.
 RESULTS: Comparison of older adults, younger adults, and amputees on the three conditions of standing eyes open, eyes closed, and on foam revealed significant differences between groups. Mean mediolateral (ML) sway distance from the center of pressure (COP), total excursions and sway velocity was significantly higher for amputees and older adults when compared to young adults (p<0.05). Furthermore, power of sway signal was substantially lower for both amputees and older adults. When compared to that of older adults, postural steadiness of amputees was more affected by the eyes closed condition, whereas older adults’ was more affected when sensory and proprioceptive information was perturbed by standing on foam. 
 CONCLUSION: Our findings showed that fall risk is greater in amputees than in young adults without amputation. Additionally, amputees may rely more heavily on visual information than proprioceptive information for balance, in contrast to older and young adults without amputation. 
 Layman's Abstract
 Falls can be detrimental to overall health and quality of life for lower extremity amputees. We evaluated postural sway and concluded that amputees have an increased fall risk and may rely more heavily on visual information for balance than do individuals without amputation.
 Article PDF Link:https://jps.library.utoronto.ca/index.php/cpoj/article/view/33804/26600
 How To Cite: Bateni H. Postural sway in lower extremity amputees and older adults may suggest increased fall risk in amputees. Canadian Prosthetics & Orthotics Journal. 2020;Volume 3, Issue 2, No.4. https://doi.org/10.33137/cpoj.v3i2.33804
 Corresponding Author: Hamid Bateni, PhD Physical Therapy Program, School of Allied Health and Communicative Disorders, Northern Illinois University, DeKalb, Illinois, USA.E-mail: hbateni@niu.eduORCID: https://orcid.org/0000-0001-9083-1817

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