The relationship of hip strength to walking and balance performance in unilateral lower limb prosthesis users differs by amputation level.
Andrew Sawers, Stefania Fatone
PMID 39119804WHAT IT FOUND
For transtibial users, residual limb hip strength predicts walking and balance.
For transfemoral users, only intact limb hip abductor strength matters. Rehabilitation should target the specific hip muscles associated with the patient's amputation level.
Key findings
01Residual limb hip extensor and abductor strength explained the majority of variance in walking speed, endurance, and balance for transtibial prosthesis users.
02For transfemoral prosthesis users, only intact limb hip abductor torque impulse was associated with walking speed, endurance, and balance.
03The study suggests transfemoral users rely on an 'intact leg strategy' because residual limb muscles are occupied with stabilizing the prosthesis.
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 small (13 per group), which limits the generalizability of the findings. The study used a stepwise data-driven approach to build models, which may have produced optimistic estimates of the variance explained. Isometric strength was measured using a dynamometer, which may not be available in all clinical settings. The study did not include dysvascular amputees or those with congenital amputations, so results apply only to non-dysvascular traumatic or surgical amputees.
Declared interests
The authors declare no competing interests.
The easy way to misread this
Do not assume that strengthening the residual limb will improve walking or balance in transfemoral prosthesis users. The study found no significant association between residual limb hip strength and functional outcomes in this group; instead, intact limb strength was the key predictor.