title: A pilot study examining measures of balance and mobility in children with unilateral lower-limb amputation.
abstract: BACKGROUND
  Individuals with unilateral lower-limb amputation (LLA) have altered structure and physiology of their lower limbs which impairs their balance, mobility, physical function and participation in physical activities. As part of (re)habilitation, focus is given to improving gait and balance in order to enhance overall mobility, function, self-efficacy, and independence. However, the relationships amongst body impairments and physical activity limitations remain unclear, particularly in the pediatric population.
  
  
  OBJECTIVE
  To provide an examination of the relationships among balance and mobility measures in children with unilateral lower-limb amputation and able-bodied children.
  
  
  METHODS
  Cross-sectional prospective comparative pilot study.
  
  
  METHODS
  Spatiotemporal gait parameters and standing postural control were evaluated in children with lower-limb amputation (n = 10) and age-matched able-bodied children (n = 10) in a laboratory-based setting. Clinical tests for mobility and balance consisted of the 10-m walk test, the 6-min walk test, and the Community Balance and Mobility scale. Energy expenditure was estimated during the 6-min walk test using the Physiological Cost Index. Analysis included comparing variables between able-bodied and lower-limb amputation groups, as well as examining the correlations among them.
  
  
  RESULTS
  Walking speed, distance, and functional balance (p < 0.05) were significantly diminished in children with lower-limb amputation compared to able-bodied children. For children with lower-limb amputation, reduced energy expenditure was associated with narrower step width and more symmetrical gait; better postural control and balance were associated with faster walking speeds (p < 0.05).
  
  
  CONCLUSIONS
  A greater clinical understanding of gait and balance deficits in this population may help to improve rehabilitation outcomes and overall functional mobility.
  
  
  CONCLUSIONS
  Improved understanding of deficits in children with lower-limb amputation (LLA) may lead to more targeted interventions and facilitate clinical decision-making in rehabilitation settings for this population. The findings contribute to the limited literature and provide a basis to further examine suitable clinical outcome measures to be used in children with LLA.
authors.affiliation: University of Toronto, Toronto, ON, Canada.
authors.forename: Emma
authors.initials: E
authors.lastname: Feick
authors.affiliation: University of Toronto, Toronto, ON, Canada.
authors.forename: Peggy-Rae
authors.initials: PR
authors.lastname: Hamilton
authors.affiliation: University of Toronto, Toronto, ON, Canada.
authors.forename: Marlene
authors.initials: M
authors.lastname: Luis
authors.affiliation: University of Toronto, Toronto, ON, Canada.
authors.forename: Melissa
authors.initials: M
authors.lastname: Corbin
authors.affiliation: University of Toronto, Toronto, ON, Canada.
authors.forename: Nancy M
authors.initials: NM
authors.lastname: Salback
authors.affiliation: University of Toronto, Toronto, ON, Canada Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Torres-Moreno
authors.affiliation: University of Toronto, Toronto, ON, Canada Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada jandrysek@hollandbloorview.ca.
authors.forename: Jan
authors.initials: J
authors.lastname: Andrysek
mesh_terms: D000222:Adaptation, Physiological; D000367:Age Factors; D000671:Amputation, Surgical / Q000379:methods / Q000534:rehabilitation*; D000674:Amputees / Q000534:rehabilitation*; D001186:Artificial Limbs; D002648:Child; D003430:Cross-Sectional Studies; D019988:Children with Disabilities / Q000534:rehabilitation; D004734:Energy Metabolism; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D035002:Lower Extremity / Q000601:surgery; D008297:Male; D051346:Mobility Limitation; D010865:Pilot Projects; D004856:Postural Balance / Q000502:physiology*; D011446:Prospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D016896:Treatment Outcome
keywords: Gait; amputation; balance; center of pressure; child; energy expenditure; gait symmetry; lower limbs; mobility; physical capacity; postural control; walk tests