Dynamic balancing responses in unilateral transtibial amputees following outward-directed perturbations during slow treadmill walking differ considerably for amputated and non-amputated side.
Andrej Olenšek, Matjaž Zadravec, Helena Burger and 1 others
PMID 34332595WHAT IT FOUND
When pushed outward on the amputated side while walking slowly, amputees cannot use ankle strategies to stabilize.
They must wait for the non-amputated leg to step across, causing large body shifts. On the non-amputated side, their balance response matches people without amputation.
Key findings
01Amputees lack in-stance balancing strategies when perturbed on the amputated side during slow walking, relying instead on a delayed stepping strategy.
02Perturbations on the amputated side resulted in significantly larger center-of-mass displacement compared to the non-amputated side and controls.
03When perturbed on the non-amputated side, amputees used in-stance strategies similar to those of people without amputation.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study included only high-functioning amputees (K3/K4 levels), so results may not apply to less experienced or lower-functioning patients. Walking speed was fixed at 0.5 m/s; strategies may differ at faster speeds where stepping is dominant for everyone. Gender distribution was uneven between groups, though qualitative comparison suggested similar responses. Only one perturbation amplitude (10% body weight) was tested.
Declared interests
Funded by the Slovenian Research Agency (Javna Agencija za Raziskovalno Dejavnost RS). No commercial conflicts of interest were reported.
The easy way to misread this
Do not assume amputees have poor balance on both sides. Their deficit is specific to the amputated side during slow walking; on the non-amputated side, their reactive balance strategies are comparable to those of people without amputation.