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

Molina‐Rueda, Francisco; Molero-Sánchez, Alberto; Alguacil-Diego, Isabel M.; Carratalá-Tejada, María; Cuesta-Gómez, Alicia; Miangolarra‐Page, Juan Carlos

doi:10.1016/j.pmrj.2015.05.024

Cited by 11 publications

(26 citation statements)

References 23 publications

(35 reference statements)

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“…The SOT and LOS test validly identify postural control impairments in the elderly fallers, differentiate fallers from nonfallers, and predict fall risk [23–26]. These FP measures are also supported as reliable and valid measures of underlying postural control deficits across neurological populations [27–30]. Specific to the PD population, Harro et al [31] reported excellent test-retest reliability for these FP measures, and fair to moderate correlation between the SOT and LOS test and clinical balance measures.…”

Section: Introductionmentioning

confidence: 99%

Comparing Balance Performance on Force Platform Measures in Individuals with Parkinson’s Disease and Healthy Adults

Harro

Kelch

Hargis

et al. 2018

Parkinson's Disease

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Introduction Postural instability is a known contributing factor to balance dysfunction and increased fall risk in those with Parkinson's disease (PD). Computerized posturography employing a force platform system provides objective, quantitative assessments of postural control impairments. This study examines balance performance as measured by force platform (FP) tests in persons with PD compared to age-matched healthy adults. Secondarily, we examine if these FP measures provide diagnostic and clinically meaningful information about the underlying balance impairments in the PD population. Methods Participants—42 individuals with PD (Hoehn and Yahr stage = 2.33 ± 0.77) and 55 age-matched healthy adults—were assessed on three standardized balance measures on a computerized force platform system. Between groups, comparisons of FP performance were analyzed using independent t-test. Within the group, comparisons for the PD cohort were analyzed using ANOVA for comparing disease stage and Mann–Whitney U test for PD subtypes. Results The PD cohort demonstrated significantly greater postural instability on the sensory organization test (SOT) measures (P=0.013, CI-95% = 1.286 to 10.37) and slower movement velocity on the limits of stability (LOS) test (P=0.001, CI-95% = 0.597 to 1.595) than the healthy cohort, suggesting that these tests were sensitive to detect sensory integration and voluntary postural control deficits in the PD cohort. Within the PD group, the SOT differentiated between H&Y stages 1–3. The motor control test (MCT) detected changes in reactive postural control mainly in later disease stages. All three FP tests distinguished between PD subtypes, with the Posture Gait Instability subtype demonstrating poorer balance performance than Tremor Dominant subtype. Conclusion These findings suggest FP measures provide clinically meaningful, diagnostic information in the examination of balance impairments in individuals with PD. FP measures may inform clinicians regarding intrinsic balance deficits and guide them in designing targeted balance interventions to reduce fall risk in persons with PD.

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Section: Introductionmentioning

confidence: 99%

Comparing Balance Performance on Force Platform Measures in Individuals with Parkinson’s Disease and Healthy Adults

Harro

Kelch

Hargis

et al. 2018

Parkinson's Disease

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“…Based on our results, the similarity of trunk RAM across patients may indicate that the trunk is the segment that drives the motion, and that the pelvis compensates. However, with training and familiarity, the unnecessary core muscle demand could be reduced, and may provide more efficient postural control resulting in a reduced risk of falling when navigating an unexpected obstacle (Marigold et al 2005; Molina-Rueda et al 2015).…”

Section: Discussionmentioning

confidence: 99%

Trunk movement compensations and corresponding core muscle demand during step ambulation in people with unilateral transtibial amputation

Gaffney

Christiansen

Murray

et al. 2018

Journal of Electromyography and Kinesiology

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The objective of this investigation was to identify demands from core muscles that corresponded with trunk movement compensations during bilateral step ambulation in people with unilateral transtibial amputation (TTA). Trunk rotational angular momentum (RAM) was measured using motion capture and bilateral surface EMG was measured from four bilateral core muscles during step ascent and descent tasks in people with TTA and healthy controls. During step ascent, the TTA group generated larger mediolateral (P = 0.01) and axial (P = 0.01) trunk RAM toward the leading limb when stepping onto the intact limb than the control group, which corresponded with high demand from the bilateral erector spinae and oblique muscles. During step descent, the TTA group generated larger trunk RAM in the sagittal (P < 0.01), frontal (P < 0.01), and transverse planes (P = 0.01) than the control group, which was an effect of falling onto the intact limb. To maintain balance and arrest trunk RAM, core muscle demand was larger throughout the loading period of step descent in the TTA group. However, asymmetric trunk movement compensations did not correspond to asymmetric core muscle demand during either task, indicating a difference in motor control compensations dependent on the leading limb.

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“…After a TTA, most individuals rely automatically on their intact leg during standing [3][4][5][6] and walking [7,8]. This strategy is even more pronounced in situations with increased demands for postural control [3,5,[9][10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

“…To maintain postural stability both automatic sensorimotor processing (beside others reflecting the adaptability and postural reactivity to unexpected environmental changes) and volitional processing have to be employed [1]. Factors, which have been previously suggested to have impact on automatic or volitional postural control in individuals after lower limb amputation include etiology of amputation [3,4], age [4], activity level, duration of prosthesis use [5,20], stump length [21,22], prosthetic components and alignment [23], fall history [3,10] or fear of falling [24]. However, there is little evidence how these factors may influence the engagement of the prosthetic and/or intact leg with respect to both automatic and volitional aspects of postural control in TTAs.…”

Section: Introductionmentioning

confidence: 99%

Postural Control Strategies and Balance-Related Factors in Individuals with Traumatic Transtibial Amputations

Kolářová

Janura

Svoboda

et al. 2021

Sensors

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Mechanisms behind compromised balance control in people with transtibial amputation need to be further explored, as currently little is known specifically about postural control strategies in people with traumatic transtibial amputation (tTTA). The aim of this study is to assess automatic and voluntary postural control strategies in individuals with unilateral tTTA compared to those in control subjects and to define the effect of balance-related factors on these strategies. Automatic posture reactions and volitional motion toward given direction using standardized posturographic protocols (NeuroCom) of the Motor Control Test (MCT) and Limits of Stability (LOS) were assessed in eighteen participants with tTTA and eighteen age-matched controls. Compared to the controls, the participants with tTTA bore less weight on the prosthetic leg (p < 0.001) during the MCT and had reduced inclination toward the prosthetic leg (p < 0.001) within the LOS. In the tTTA group, the weight-bearing symmetry and the inclination toward the prosthetic leg (p < 0.05) was positively correlated with prosthesis use duration (p < 0.05). The current study indicates that decreased utilization of the prosthetic leg in tTTAs represents adaptive postural control strategy, but as prosthesis use duration increased, the engagement of the prosthetic leg improved.

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

Cited by 11 publications

References 23 publications

Comparing Balance Performance on Force Platform Measures in Individuals with Parkinson’s Disease and Healthy Adults

Comparing Balance Performance on Force Platform Measures in Individuals with Parkinson’s Disease and Healthy Adults

Trunk movement compensations and corresponding core muscle demand during step ambulation in people with unilateral transtibial amputation

Postural Control Strategies and Balance-Related Factors in Individuals with Traumatic Transtibial Amputations

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