Selecting, Administering, and Interpreting Outcome Measures Among Adults with Lower-Limb Loss: an Update for Clinicians

Sions, Jaclyn Megan; Beisheim, Emma Haldane; Seth, Mayank

doi:10.1007/s40141-020-00274-4

Cited by 20 publications

(21 citation statements)

References 97 publications

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“…The extensive experience gained in the use of the TUG test in subjects with motor difficulties provides a rationale for its use to evaluate mobility also in lower limb amputees, paying specific attention to the different motor tasks included in the test. The TUG test was validated in people with a lower limb amputation [ 15 , 16 ], showing significant increase in the total time required to travel the entire path, when compared with the times measured in non-amputees [ 15 , 16 , 17 , 18 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

Use of a Single Wearable Sensor to Evaluate the Effects of Gait and Pelvis Asymmetries on the Components of the Timed Up and Go Test, in Persons with Unilateral Lower Limb Amputation

Valle

Casabona

Sapienza

et al. 2021

Sensors

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The Timed Up and Go (TUG) test quantifies physical mobility by measuring the total performance time. In this study, we quantified the single TUG subcomponents and, for the first time, explored the effects of gait cycle and pelvis asymmetries on them. Transfemoral (TF) and transtibial (TT) amputees were compared with a control group. A single wearable inertial sensor, applied to the back, captured kinematic data from the body and pelvis during the 10-m walk test and the TUG test. From these data, two categories of symmetry indexes (SI) were computed: One SI captured the differences between the antero-posterior accelerations of the two sides during the gait cycle, while another set of SI quantified the symmetry over the three-dimensional pelvis motions. Moreover, the total time of the TUG test, the time of each subcomponent, and the velocity of the turning subcomponents were measured. Only the TF amputees showed significant reductions in each SI category when compared to the controls. During the TUG test, the TF group showed a longer duration and velocity reduction mainly over the turning subtasks. However, for all the amputees there were significant correlations between the level of asymmetries and the velocity during the turning tasks. Overall, gait cycle and pelvis asymmetries had a specific detrimental effect on the turning performance instead of on linear walking.

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Section: Introductionmentioning

confidence: 99%

Use of a Single Wearable Sensor to Evaluate the Effects of Gait and Pelvis Asymmetries on the Components of the Timed Up and Go Test, in Persons with Unilateral Lower Limb Amputation

Valle

Casabona

Sapienza

et al. 2021

Sensors

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“…Alternatively, and if applied to dual‐task cost, pairwise comparisons may be sufficient to assess if a greater magnitude of change in performance between single‐task and dual‐task conditions is observed in PLLA relative to CN. To avoid underpowered studies that minimize the ability to observe a true effect, a priori sample size calculations should be reported and be based on effect sizes from similar published research or be informed by a protocol pilot. Although a demand exists for the assessment of balance and gait using instrumented technology, future research on dual‐task testing using clinical tests is also important because of its clinical applicability. Currently, many clinical tests of mobility are available 13,14 ; however, the L Test of Functional Mobility remains the only test specifically designed for PLLA and for which a condition of dual‐task has been shown to be valid and reliable 24,29,30,62 . Dual‐task testing assesses cognitive‐motor capacity, and offers healthcare professionals the ability to examine situations resembling real life 22,23 that are often associated with experiences of falls 63 .…”

Section: Discussionmentioning

confidence: 99%

“…Unsurprisingly, falls are also common in PLLA 9,10 and can have serious consequences that affect numerous aspects of life 11 . As most falls occur while walking, 12 the assessment of gait in PLLA is considered essential for tracking rehabilitation progress and successful community reintegration 13,14 …”

Section: Introductionmentioning

confidence: 99%

“…11 As most falls occur while walking, 12 the assessment of gait in PLLA is considered essential for tracking rehabilitation progress and successful community reintegration. 13,14 Gait is a complex motor task demanding of cognitive resources even when regulating routine walking. 15,16 Independent living requires increased cognitive and motor function as it involves navigating surroundings and completing transfers, turns, outdoor walking, and the negotiation of obstacles and gait aids.…”

Section: Introductionmentioning

confidence: 99%

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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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“…The FSST assesses dynamic balance through multidirectional stepping. 19 Participants complete a sequence of steps over 4 canes arranged in a “+” as fast as safely possible without touching the canes ( fig 1 ). 20 After demonstration, participants completed 1 practice and 2 timed trials (recorded in seconds, without examiner cueing for sequencing to avoid participant pacing).…”

Section: Methodsmentioning

confidence: 99%

Vibration Sensitivity Is Associated With Functional Balance After Unilateral Transtibial Amputation

Seth

Beisheim‐Ryan

Pohlig

et al. 2021

Archives of Rehabilitation Research and Clinical Translation

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Selecting, Administering, and Interpreting Outcome Measures Among Adults with Lower-Limb Loss: an Update for Clinicians

Cited by 20 publications

References 97 publications

Use of a Single Wearable Sensor to Evaluate the Effects of Gait and Pelvis Asymmetries on the Components of the Timed Up and Go Test, in Persons with Unilateral Lower Limb Amputation

Use of a Single Wearable Sensor to Evaluate the Effects of Gait and Pelvis Asymmetries on the Components of the Timed Up and Go Test, in Persons with Unilateral Lower Limb Amputation

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

Vibration Sensitivity Is Associated With Functional Balance After Unilateral Transtibial Amputation

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