Mixed methods analysis of an interdisciplinary intervention to promote balance confidence in lower limb prosthesis users.
Noah J Rosenblatt, Kristin L Schneider, Steven A Miller and 8 others
PMID 40959746WHAT IT FOUND
An interdisciplinary intervention combining virtual reality balance training with cognitive behavioral therapy significantly improved balance confidence and gait self-efficacy in lower limb prosthesis users.
Participants showed large gains in these areas, though physical activity levels unexpectedly decreased.
Key findings
01Balance confidence and gait self-efficacy significantly improved in the intervention group but not the control group, with large effect sizes.
02Community participation measures showed mixed results; some improved significantly while others did not, and step counts decreased in the intervention group.
03Qualitative interviews indicated participants valued the integration of physical therapy and psychological support, though some found homework burdensome.
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 sample size was very small (19 randomized), leading to a post-hoc change in statistical analysis plan that limited the ability to detect interactions. The control group received minimal attention (one session) compared to the intervention group (up to eight sessions), so improvements may reflect attention rather than the specific intervention components. Participants were highly motivated volunteers, which may not generalize to the broader prosthesis user population. Attrition was high, with only 4 control and 9 CBPT participants having complete post-treatment data for most analyses.
Declared interests
The study was funded by the U.S. Department of Defense (Award Number: W81XWH-17–1-0697).
The easy way to misread this
Do not assume the decrease in step counts indicates harm or failure. The authors suggest this may reflect a change in activity patterns based on a better understanding of actual abilities, or that the measure is insensitive to behavioral changes in this population.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →