Clinical measures of balance and gait cannot differentiate somatosensory impairments in people with lower-limb amputation.
B A Petersen, P J Sparto, L E Fisher
PMID 36375214WHAT IT FOUND
Standard balance and gait tests distinguish people with lower-limb amputation from able-bodied individuals, but they fail to detect differences in somatosensory integrity within the amputation group.
Sensation loss was not associated with worse scores on these common clinical measures.
Key findings
01People with lower-limb amputation showed significantly slower gait speed, greater sway without vision, and lower Functional Gait Assessment scores compared to able-bodied controls.
02Within the amputation group, those with impaired sensation did not differ significantly from those with intact sensation on measures of static balance, reactive balance, dynamic balance, or gait stability.
03The study suggests that current clinical outcome measures are not able to distinguish between differences in somatosensory integrity in people with lower-limb amputation.
STILL TO COME
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What it does not show
Small sample size (20 participants with amputation). Sensory measures used (monofilament) are crude and may not detect mild-to-moderate impairments. Reactive balance was only measured on the intact limb, as responses on the prosthetic side were often undetectable. Gait kinematics were only collected from 12 of the 20 amputees. The study excluded individuals with phantom limb pain, which affects up to 80% of this population.
Declared interests
Funded by the National Institutes of Health (N.I.H., Extramural). No other conflicts of interest were reported in the provided text.
The easy way to misread this
Do not conclude that somatosensory loss has no functional impact on people with lower-limb amputation. The study found no difference on these specific tests, which the authors argue means the tests are insensitive to sensory deficits, not that the deficits are irrelevant.