BALANCE TRAINING DURING LOWER LIMB PROSTHESIS
DOI:
https://doi.org/10.11603/1811-2471.2024.v.i2.14729Keywords:
transtibial amputation, stable platform, balance training, prosthetics, pre-prosthetic rehabilitationAbstract
SUMMARY. The aim – to assess the effectiveness of physical therapy methods in pre-prosthetic rehabilitation regarding balance and functional outcomes in users of transtibial prostheses.
Material and Methods. The study included 16 people after transtibial amputation who were equipped with transtibial prostheses. The patients were in pre-prosthetic training in the subacute period of rehabilitation and were learning to use temporary prostheses. The age range of the patients was from 24 to 44 years (mean age 32.2±2.2 years). The period after amputation was 30 to 40 days (on average 36.4±1.7 days). 2 groups were created: the control group (CG), which included 7 people who underwent planned standard rehabilitation, which included basic training; the experimental group (EG), in which there were 9 patients, who were added to the scheduled rehabilitation program with balance training exercises on the TYMO stability platform.
Results. At the beginning of the study, the VAS indicators, the Berg balance scale and the Barthel index did not statistically differ between the groups (p>0.05). After the study, after 2 weeks there were changes in VAS, both in CG and in EG, the indicator of VAS in CG decreased by 15.5 % in EG decreased by 37.5 %, there was a significant difference in EG (p<0.05). The use of exercises on a stable platform in EG contributed to the even distribution of the load on the amputated segment, which reduced pressure and irritation on the tissues surrounding the stump and helped to reduce the pain syndrome. There were also changes after 14 days in the indicators of the Berg balance scale and the Barthel index in EG (p<0.05). Additional use of exercises on a stable platform contributes not only to improving balance, but also to greater functionality of the amputated limb.
Conclusions. Inclusion in the rehabilitation program of patients after transtibial amputation, during preprosthetic training, training on a stable platform contributes to the reduction of pain syndrome during physical activity, improvement of balance and quality of everyday life.
References
Jamieson, A. G., Murray, L., & Buis, A. (2020). The Use of Physical Activity Outcomes in Rehabilitation Interventions for Lower Limb Amputees: a Systematic Review. Canadian prosthetics & orthotics journal, 3(1), 33931. DOI: 10.33137/cpoj.v3i1.33931.
Nederhand, M.J., Van Asseldonk, E.H.F., van der Kooij, H., & Rietman, H.S. (2012). Dynamic Balance Control (DBC) in lower leg amputee subjects; contribution of the regulatory activity of the prosthesis side. Clin. Biomech., 27, 40-45. DOI: 10.1016/j.clinbiomech.2011.07.008.
Bolger, D., Ting, L. H., & Sawers, A. (2014). Individuals with transtibial limb loss use interlimb force asymmetries to maintain multi-directional reactive balance control. Clinical biomechanics (Bristol, Avon), 29(9), 1039-1047. DOI: 10.1016/j.clinbiomech.2014.08.007.
Schafer, Z.A., & Vanicek, N. (2021). A block randomised controlled trial investigating changes in postural control following a personalised 12-week exercise programme for individuals with lower limb amputation. Gait & posture, 84, 198-204. DOI: 10.1016/j.gaitpost. 2020.12. 001.
Vu, K., Payne, M. W. C., Hunter, S. W., & Viana, R. (2019). Risk Factors for Falls in Individuals With Lower Extremity Amputations During the Pre-Prosthetic Phase: A Retrospective Cohort Study. PM & R: the journal of injury, function, and rehabilitation, 11(8), 828-833. DOI: 10.1002/pmrj.12046.
Guerra, G., & Smith, J.D. 2021 Correlates of Balance and Aerobic Indices in Lower-Limb Prostheses Users on Arm Crank Exercise. Sensors (Basel), 21(20), 6917. DOI: 10.3390/s21206917.
Yiğiter, K., Sener, G., & Bayar, K. (2002). Comparison of the effects of patellar tendon bearing and total surface bearing sockets on prosthetic fitting and rehabilitation. Prosthetics and orthotics international, 26(3), 206-212. DOI: 10.1080/03093640208726649.
