Error-augmentation gait training to improve gait symmetry in patients with non-traumatic lower limb amputation: A proof-of-concept study.
Paul W Kline, Amanda M Murray, Matthew J Miller and 2 others
PMID 31018771WHAT IT FOUND
Four adults with non-traumatic lower limb amputation completed a single error-augmentation treadmill session safely and found it acceptable.
Gait symmetry changed, but responses varied and no consistent sustained improvement was seen.
Key findings
01All four participants completed the error-augmentation treadmill protocol as prescribed, with no falls, injuries, increased pain, excessive heart rate, or residual limb skin breakdown.
02Participants rated interest and enjoyment at 6.5 ± 0.3 on a 7-point scale, meeting the authors' threshold for good acceptability.
03Step length and stance time asymmetry changed after the session, but responses varied and no consistent sustained improvement was seen; the authors could not tell whether this was due to error-augmentation or additional walking volume.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only four participants were enrolled, so the results cannot show how larger groups of people with non-traumatic lower limb amputation would respond. The study was a single-day proof-of-concept design, and a priori sample size calculations and formal statistical significance testing were not performed. The authors could not determine whether gait changes were due to error-augmentation or additional walking volume. Retention was assessed only after a 20-minute washout, so long-term effects are unknown. Participants had to be able to walk four minutes without rest or an assistive device, so the findings may not apply to people with lower walking tolerance. The sample was recruited from a Veterans Affairs hospital and included adults with diabetes mellitus or peripheral artery disease, so results may not apply to other settings or causes of amputation.
The easy way to misread this
Do not conclude that error-augmentation treadmill training improves gait symmetry in people with non-traumatic lower limb amputation. The study had only four participants, no formal statistical significance testing, and the authors reported no consistent sustained improvement after a 20-minute washout.