Adaptation to Altered Balance Conditions in Unilateral Amputees Due to Atherosclerosis: A Randomized Controlled StudyBy Mayer, Agnes; Tihanyi, Jozsef; Bretz, Karoly; Csende, Zsolt; Bretz, Eva; Horvath, Monika; BMC Musculoskeletal Disorders, Volume 12, Number 118
Publication Date: 2011
Study examined adaptation strategies in balance following unilateral tibial amputation due to vascular insufficiency in skilled prosthetic users (SPUs) and first fitted amputees (FFAs). Participants were 10 SPUs and 18 FFAs with a mean age of 63 years, 8 of whom were female. Excursions of center of pressure (COP) were determined during 20 seconds of quiet standing using a stabilometry system while concentrating on a target located 2 meters away at eye level. Participants stood on the force platform in a double leg as well as a single leg stance, shifting weight during the latter to the intact leg. Main outcome measures were COP trajectories and time function, distribution of reaction forces between the two legs, and inclination angles obtained through second order regression analysis using stabilogram data. FFAs versus SPUs demonstrated 27.8 percent greater postural sway in bilateral stance. The postural sway area was smaller in FFAs standing on the non-affected leg compared with SPUs. The slope of the regression line indicating postural stability was nearly identical in FFAs and SPUs, and the direction of regression line was opposite for the left and right leg amputees. Based on study results, the authors conclude that of two adaptation strategies in balance, the first appears before amputation due to pain in the affected leg, while the second adaptation occurs during rehabilitation and regular use of the prosthesis, resulting in normal weight bearing associated with reduced postural sway on two legs and return to the normal postural stability on one leg.
Published by: BioMed Central Ltd (Website:http://www.biomedcentral.com)
Link to text: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3125253/pdf/1471-2474-12-118.pdf