gms | German Medical Science

Background: People with lower limb loss fall more frequently than healthy population. One of the risk factors is having trans-tibial amputation [1], [2].

Aim: We studied dynamic balance during perturbed walking in active people after trans-tibial amputation with no severe limitations in functioning.

Method: Until now we included two subjects fulfilling the inclusion criteria (will include more and present the results of all).

Subject were walking on the instrumented treadmill with the BAR device. After initial warm-up period magnitude of perturbations was determined followed by a period of perturbed walking where perturbations were delivered randomly seven times in forward, backward, left and right directions at either left or right hell contact. Speed of treadmill was set to 0.5 m/s.

Results/findings: Responses at the non-amputated side were very similar to responses observed in healthy individuals. Responses to perturbations that occurred when the amputated limb entered stance phase have shown lack of both “ankle” and “hip” strategies while the subject relied solely on the stepping strategy. The consequence of such delayed responses was much larger excursion of COM as compared to the responses on the opposite limb.

Discussion and conclusions: In included subjects the capacity to successfully recover from loss of balance during walking is very much reduced when perturbation commences on the amputated side. This type of perturbations is much more fall-threatening and should be adequately addressed by training.