Standing balance in trans-tibial amputees following vascular disease or trauma

Abstract

Standing balance measured as sway and standing time both on one and two legs, was studied by use of a stable force platform (Kistler) in 36 patients aged 48–87 years with trans-tibial amputation and 27 healthy subjects matched for age. The aim of the study was to compare postural function in standing in two groups with unilateral trans-tibial amputations, separating vascular disease from trauma. Results revealed that the vascular group had a significantly increased sway in the lateral direction compared with the healthy group, when standing on both feet close together for 30 seconds, looking straight ahead or blindfolded (p values ranging from 0.003 to 0.02). In the sagittal direction the trauma amputees had a significantly decreased sway when looking straight ahead, compared to the vascular and healthy groups (p values = 0.03). No significant differences in the lateral or sagittal direction were seen among the three groups when comparing standing on one leg. There was a significant difference, however, in the standing time in the one-leg standing test of the vascular group when compared with the trauma and healthy groups (p values ranging from 0.0009 to 0.02). In contrast to the vascular group, all subjects in the trauma and healthy groups from 48 to 59 years could stand on the healthy leg for 30 seconds when looking straight ahead, and from 60 to 79 years they could stand for 5 seconds. None in the vascular or trauma group older than 80 years could stand on the healthy leg for 5 seconds. The standing balance of the vascular amputees was found to be inferior to that of the trauma amputees. In conclusion, vascular and trauma trans-tibial amputees should not be considered as an entity in test situations or rehabilitation programmes.

Does diabetes affect stability in people with unilateral transtibial amputation?

“…The OLST test provided useful information about the static stability of below-knee amputees. Hermodsson et al [18], in their comprehensive analysis, reported results similar to those in the present study. The standing balance capacity of the traumatic amputees is good.…”

“…In the Timed One-Legged Stance Test (OLST) for the amputees, the subjects were standing first on the contralateral leg, then on the prosthetic leg [18].…”

Weight Symmetry and Latency Scores for Unexpected Surface Perturbations in Subjects With Traumatic and Vascular Unilateral Transtibial Amputation

“…However, it is known that persons with a lower limb amputation as a result of vascular disease have more restrictions in their activities of daily living than do subjects who have had an amputation for another reason [17,18]. Understanding how subjects with amputation respond to unexpected perturbations could have important implications for their rehabilitation because subjects with vascular and traumatic transtibial amputation should not be considered as a single entity in rehabilitation programs [19].…”

Nonlinear analysis of postural sway in subjects with below knee amputation during opened and closed eye conditions

“…Stability of below knee amputees has been investigated in a few studies based on questionnaire or use of linear approaches. [16][17][18][19] However, it was not clear whether the structure of postural sway of amputees differs from that of normal subjects or not. Analyzing postural sway in people with the below knee amputees using nonlinear approaches may clarify that exactly what differences in structure of postural sway exists in the people with amputees in comparison to the healthy people.…”