Deterioration of balance control after limb-saving surgery.
OBJECTIVE
Evaluation of the changes in balance control observed in patients after limb-saving surgery for malignant tumors of the lower limb.


METHODS
Case series.


RESULTS
In 11 patients who underwent limb-saving surgery and 10 healthy, age-matched controls, displacement of the amplitude of the center of pressure (ACP) and velocity of the center of pressure (VCP) during normal standing and standing on a balance board were registered. Adding such constraints as standing with eyes closed and performing a Stroop task made standing more complex. During normal standing and on the balance board, both groups showed comparable ACP and VCP values. With eyes closed, both patients and controls showed a higher amplitude and velocity in the anterior-posterior direction. In the patient group, the Stroop task affected the ACP (4.5 +/- 0.8 mm) compared with normal standing (2.9 +/- 0.4 mm) and VCP (18.6 +/- 3.0 mm/sec) compared with normal standing (11.9 +/- 1.0 mm/sec). During balance board standing, the authors found a difference in the VCP for both groups whose eyes were closed and who performed under dual-task conditions (controls, 23.2 +/- 3.3 and 14.9 +/- 2.9 mm/sec; patients, 80.1 +/- 12.9 and 23.6 +/- 3.4 mm/sec).


CONCLUSIONS
Although the patient group showed impressive upright standing after limb-saving surgery, upright standing become more difficult under higher visual and cognitive loads. This finding indicates that the level of postural automatism is not complete in these patients.
de Visser
E
E
Department of Medicine and Biophysics, University of Nijmegen, The Netherlands.
Deckers
J A
JA
Veth
R P
RP
Schreuder
H W
HW
Mulder
T W
TW
Duysens
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D002813:Chondrosarcoma / Q000534:rehabilitation / Q000601:surgery*; D003071:Cognition; D005260:Female; D005266:Femoral Neoplasms / Q000534:rehabilitation / Q000601:surgery*; D006801:Humans; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D012516:Osteosarcoma / Q000534:rehabilitation / Q000601:surgery*; D011184:Postoperative Period; D004856:Postural Balance