Toward more intuitive prosthetic control: structured residual muscle training in transtibial amputees.
Faranak Rostamjoud, Friðrika Björk Þorkelsdóttir, Atli Örn Sverrisson and 2 others
PMID 41992246WHAT IT FOUND
Four weeks of daily residual limb exercises improved muscle control accuracy and stability in eight transtibial amputees.
Adding supervised biofeedback sessions produced no greater gains than home exercise alone. One participant withdrew due to recurrent phantom pain, highlighting the need for screening.
Key findings
01Home exercise alone improved muscle activation accuracy, signal stability, and selectivity, with no significant advantage for the group that also received supervised biofeedback.
02Improvements were uneven: gastrocnemius and peroneus longus showed significant gains, while tibialis anterior showed negligible change.
03One participant withdrew after four weeks due to recurrent phantom and neuropathic pain, which resolved after stopping training.
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 (n=9 recruited, n=8 analysed) and all participants were male, limiting generalisability. Groups were assigned based on practical availability rather than randomisation, introducing potential selection bias. The study was not powered to detect differences between the two training approaches, so the lack of benefit from biofeedback might be due to insufficient statistical power rather than true equivalence. Improvements were not tracked beyond four weeks, so it is unknown if gains persist. Individual variability was high, with some participants showing no improvement, particularly the congenital amputee.
Declared interests
Funded by the Icelandic Center for Research. No other conflicts of interest declared in the provided text.
The easy way to misread this
Do not conclude that biofeedback is ineffective. The study was small and underpowered to detect differences between groups, and the biofeedback dose was modest. The null result for group differences means biofeedback might still offer advantages not measured here, such as engagement or long-term retention.
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 →