Margins of stability in young adults with traumatic transtibial amputation walking in destabilizing environments.
Understanding how lower-limb amputation affects walking stability, specifically in destabilizing environments, is essential for developing effective interventions to prevent falls. This study quantified mediolateral margins of stability (MOS) and MOS sub-components in young individuals with traumatic unilateral transtibial amputation (TTA) and young able-bodied individuals (AB). Thirteen AB and nine TTA completed five 3-min walking trials in a Computer Assisted Rehabilitation ENvironment (CAREN) system under each of three test conditions: no perturbations, pseudo-random mediolateral translations of the platform, and pseudo-random mediolateral translations of the visual field. Compared to the unperturbed trials, TTA exhibited increased mean MOS and MOS variability during platform and visual field perturbations (p<0.010). AB exhibited increased mean MOS during visual field perturbations and increased MOS variability during both platform and visual field perturbations (p<0.050). During platform perturbations, TTA exhibited significantly greater values than AB for mean MOS (p<0.050) and MOS variability (p<0.050); variability of the lateral distance between the center of mass (COM) and base of support at initial contact (p<0.005); mean and variability of the range of COM motion (p<0.010); and variability of COM peak velocity (p<0.050). As determined by mean MOS and MOS variability, young and otherwise healthy individuals with transtibial amputation achieved lateral stability similar to that of their able-bodied counterparts during unperturbed and visually-perturbed walking. However, based on mean and variability of MOS, unilateral transtibial amputation was shown to have affected lateral walking stability during platform perturbations.
Center for the Intrepid, Department of Orthopaedics and Rehabilitation, Brooke Army Medical Center, Ft. Sam Houston, TX 78234, USA.
Eduardo J
EJ
Beltran
Department of Kinesiology & Health Education, University of Texas, Austin, TX 78712, USA.
Jonathan B
JB
Dingwell
Center for the Intrepid, Department of Orthopaedics and Rehabilitation, Brooke Army Medical Center, Ft. Sam Houston, TX 78234, USA. Electronic address: Jason.wilken@us.army.mil.
Jason M
JM
Wilken
D000293:Adolescent; D000328:Adult; D000673:Amputation, Traumatic / Q000503:physiopathology*; D016022:Case-Control Studies; D004777:Environment; D005260:Female; D005684:Gait; D006801:Humans; D008297:Male; D009038:Motion; D004856:Postural Balance; D014794:Visual Fields; D016138:Walking / Q000502:physiology*; D055815:Young Adult
Center of mass; Lateral stability; Perturbations; Transtibial amputation; Walking