title: The effect of a supervised community-based exercise program on balance, balance confidence, and gait in individuals with lower limb amputation.
abstract: BACKGROUND
  Many individuals with lower limb loss report concern with walking ability after completing structured traditional rehabilitation.
  
  
  OBJECTIVE
  The purpose of this study was to explore the impact of a supervised community-based exercise program on balance, balance confidence, and gait in individuals with lower limb amputation.
  
  
  METHODS
  Repeated measures.
  
  
  METHODS
  The supervised exercise program was offered biweekly for 6 weeks. The GAITRite System by CIR Systems, Inc., the Figure-of-8 Walk Test, and Activity-specific Balance Confidence Scale were used to measure clinical outcomes pre- and post-intervention.
  
  
  RESULTS
  In total, 16 participants with lower limb amputation (mean age: 50.8 years) completed the study. A multivariate, repeated measures analysis of variance indicated a statistically significant effect of training across six clinical outcome measures ( F(6, 10) = 4.514, p = .018). Moderate effect sizes were found for the Figure-of-8 Walk Test ( η2= .586), Activity-specific Balance Confidence Scale ( η2= .504), and gait velocity at comfortable walking speed ( η2= .574). The average increase in gait speed was clinically meaningful at .14 m/s.
  
  
  CONCLUSIONS
  The supervised community-based exercise program implemented in this study was designed to address specific functional needs for individuals with lower limb loss. Each participant experienced clinically meaningful improvements in balance, balance confidence, and walking ability. Clinical relevance The provision of a supervised community-based exercise program, after traditional rehabilitation, provides opportunity to offer a continuum of care that may enhance prosthetic functional ability and active participation in the community for individuals with lower limb amputation.
authors.affiliation: 1 Philadelphia College of Osteopathic Medicine, Suwanee, GA, USA.
authors.forename: Carol A
authors.initials: CA
authors.lastname: Miller
authors.affiliation: 2 University of North Georgia, Dahlonega, GA, USA.
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Williams
authors.affiliation: 2 University of North Georgia, Dahlonega, GA, USA.
authors.forename: Katey L
authors.initials: KL
authors.lastname: Durham
authors.affiliation: 2 University of North Georgia, Dahlonega, GA, USA.
authors.forename: Selena C
authors.initials: SC
authors.lastname: Hom
authors.affiliation: 2 University of North Georgia, Dahlonega, GA, USA.
authors.forename: Julie L
authors.initials: JL
authors.lastname: Smith
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000671:Amputation, Surgical / Q000379:methods / Q000534:rehabilitation*; D000674:Amputees / Q000534:rehabilitation*; D001186:Artificial Limbs; D015331:Cohort Studies; D003153:Community Health Services / Q000458:organization & administration; D005081:Exercise Therapy / Q000458:organization & administration*; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D018579:Patient Selection; D004856:Postural Balance / Q000502:physiology*; D015397:Program Evaluation; D011446:Prospective Studies; D011788:Quality of Life; D016896:Treatment Outcome; D014481:United States
keywords: Rehabilitation of prostheses users; balance and balance confidence; community-based exercise; gait; rehabilitation