Literature DB >> 12528576

Outcomes after trans-tibial amputation: the relationship between quiet stance ability, strength of hip abductor muscles and gait.

Heidi Nadollek1, Sandra Brauer, Rosemary Isles.   

Abstract

BACKGROUND AND
PURPOSE: Previous research regarding the symmetry of trans-tibial amputees has examined weight distribution and various gait parameters between prosthetic and sound limbs. However, to date, no known research has determined if asymmetry is present in the strength of the hip abductor muscles or if correlations exist between these categories of symmetry. The purpose of the present study was, therefore, to document asymmetry present in stance, strength and gait measures, and to determine the relationship between these variables.
METHOD: Twenty-three elderly, unilateral trans-tibial amputees stood on two adjacent forceplates whilst the weight distribution and standard deviation (SD) of the anterior-posterior and the medio-lateral centre of pressure excursion (COPE) under each limb was recorded during four 40 s trials: quiet stance (QS), with eyes open and eyes closed; and even stance (ES), with eyes open and eyes closed. Gait measures (velocity, cadence, step and stride lengths, stance:swing ratio and period of double support) over 10 m of fast, yet safe walking and measures of the strength of hip abductor muscles were also obtained by use of a stride analyser and a dynamometer, respectively.
RESULTS: No significant differences were found between QS and ES measures. However, significantly more weight was taken on the sound limb than on the amputated limb. Notably, more anterior-posterior movement occurred under the sound limb than the amputated limb, with this becoming more apparent with the eyes closed. Movement in the medio-lateral direction was found to be the same between sides. No differences in muscle strength or gait measures between limbs were demonstrated. However, strong hip abductor muscles were correlated with increased weight-bearing on the amputated limb, improved gait parameters and reduced medio-lateral COPE under the amputated limb.
CONCLUSIONS: This research confirms the asymmetrical nature of amputee stance and demonstrates symmetry of strength and gait measures between limbs. The correlations between hip abductor muscle strength, weight distribution and gait measures illustrates the importance of pre- and post-operative training of these muscles.

Entities:  

Mesh:

Year:  2002        PMID: 12528576     DOI: 10.1002/pri.260

Source DB:  PubMed          Journal:  Physiother Res Int        ISSN: 1358-2267


  20 in total

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2.  Changes in the relative contribution of each leg to the control of quiet two-legged stance following unilateral plantar-flexor muscles fatigue.

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3.  Trunk kinetic effort during step ascent and descent in patients with transtibial amputation using angular momentum separation.

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4.  Residual and sound limb hip strength distinguish between sedentary and nonsedentary adults with transtibial amputation.

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5.  Gait asymmetry is associated with performance-based physical function among adults with lower-limb amputation.

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6.  The effects of walking speed and prosthetic ankle adapters on upper extremity dynamics and stability-related parameters in bilateral transtibial amputee gait.

Authors:  Matthew J Major; Rebecca L Stine; Steven A Gard
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7.  Individuals with transtibial limb loss use interlimb force asymmetries to maintain multi-directional reactive balance control.

Authors:  Darren Bolger; Lena H Ting; Andrew Sawers
Journal:  Clin Biomech (Bristol, Avon)       Date:  2014-08-23       Impact factor: 2.063

8.  Considering passive mechanical properties and patient user motor performance in lower limb prosthesis design optimization to enhance rehabilitation outcomes.

Authors:  Matthew J Major; Nicholas P Fey
Journal:  Phys Ther Rev       Date:  2017-07-17

9.  Contribution of each leg to the control of unperturbed bipedal stance in lower limb amputees: new insights using entropy.

Authors:  Petra Hlavackova; Céline Franco; Bruno Diot; Nicolas Vuillerme
Journal:  PLoS One       Date:  2011-05-13       Impact factor: 3.240

10.  The relationship between body composition, anaerobic performance and sprint ability of amputee soccer players.

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