Temporal-Spatial Values During a 180° Step Turn in People with Unilateral Lower Limb Amputation

Abstract Objective The modified Clinical Test of Sensory Interaction and Balance (mCTSIB) is used to clinically assess vestibular sensory integration (VSI), the process by which the central nervous system integrates vestibular afference to maintain balance. The rate and effects of impaired VSI (IVSI) on prosthetic mobility in people with lower limb amputation (LLA) is unknown. The objective of this study was to use the mCTSIB to classify VSI in active community ambulators with LLA and to examine the relationship between IVSI and prosthetic mobility, as measured by the Component Timed Up and Go (cTUG) test. Methods This was a cross-sectional study with a convenience sample of 130 community ambulators with unilateral LLA. Classification of VSI was determined based on a time-based pass/fail mCTSIB performance. Participants were classified as having normal sensory integration (NSI) if they could balance for 30 seconds in every mCTSIB condition. Participants who failed condition 4 exclusively were classified as IVSI. Prosthetic mobility, as measured by the cTUG, was compared between NSI and IVSI groups. Results Of the 130 participants, 29 (22%) were classified as IVSI and 95 (73%) were classified as having NSI. Prosthetic mobility significantly differed between IVSI and NSI groups, with IVSI participants performing all components of the cTUG significantly slower. Medium to large effect sizes were found between groups during cTUG. Conclusions These results suggest that 1 in 5 community ambulators with LLA have IVSI, with associated limitations in balance confidence and prosthetic mobility. Impact The ability to integrate vestibular information was found to have a strong relationship with prosthetic mobility in active community ambulators with LLA, especially with performing a 180-degree step turn. Physical therapists can use the mCTSIB to classify sensory integration during prosthetic rehabilitation and develop an appropriate balance intervention. Lay Summary Active adults with LLA can use information from their senses to maintain their standing balance. Adults with LLA who have difficulty balancing on foam with closed eyes were slower to get in and out of a chair, walk, and perform a 180-degree step turn.

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Metric Charcteristics of Sit-to-stand Tests in Patients After Lower-limb Amputation

Case Medical Research ◽

10.31525/ct1-nct04293237 ◽

2020 ◽

Author(s):

Keyword(s):

Lower Limb ◽

Lower Limb Amputation ◽

Limb Amputation ◽

Sit To Stand

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Prostheses and orthoses. Factors to be considered when specifying a prosthesis for a person who has had a lower limb amputation

10.3403/30178636 ◽

2009 ◽

Keyword(s):

Lower Limb ◽

Lower Limb Amputation ◽

Limb Amputation

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Prostheses and orthoses. Factors to be included when describing physical activity of a person who has had a lower limb amputation(s) or who has a deficiency of a lower limb segment(s) present at birth

10.3403/30178633u ◽

2015 ◽

Keyword(s):

Physical Activity ◽

Lower Limb ◽

Lower Limb Amputation ◽

Limb Amputation ◽

Limb Segment

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Prostheses and orthoses. Factors to be included when describing physical activity of a person who has had a lower limb amputation(s) or who has a deficiency of a lower limb segment(s) present at birth

10.3403/30178633 ◽

2009 ◽

Keyword(s):

Physical Activity ◽

Lower Limb ◽

Lower Limb Amputation ◽

Limb Amputation ◽

Limb Segment

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P90 PERCEIVE: PrEdiction of Risk and Communication of outcome following major lower limb amputation - a collaboratIVE study

BJS Open ◽

10.1093/bjsopen/zrab032.089 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

Author(s):

B Gwilym ◽

C Waldron ◽

E Thomas-Jones ◽

P Pallmann ◽

R Preece ◽

...

Keyword(s):

Risk Prediction ◽

Lower Limb ◽

Health Care Professionals ◽

Healthcare Professionals ◽

Demographic Data ◽

Collaborative Study ◽

Lower Limb Amputation ◽

Research Network ◽

Limb Amputation ◽

Prediction Tools

Abstract Introduction Major Lower Limb Amputation (MLLA) is a life changing event with significant morbidity and mortality. Inaccurate risk prediction can lead to poor decision making, resulting in delay to definitive surgery, or undertaking amputation when not in the patient’s best interest. We aim to answer: In adult patients undergoing MLLA for chronic limb threatening ischaemia or diabetes, how accurately do health care professionals prospectively predict outcomes after MLLA, and how does this compare to existing prediction tools? Methods A multicentre prospective observational cohort study is being delivered through the Vascular and Endovascular Research Network. Dissemination was via an existing network of contacts and social media. Consecutive data will be collected for seven months from site launch date, including demographic data and pre-operative outcome predictions from surgeons, anaesthetists, and allied healthcare professionals. Follow-up data will comprise 30-day (mortality, morbidity, MLLA revision, surgical site infection, and blood transfusion) and 1-year (mortality, MLLA revision and ambulation). The accuracy of surgeons’ predictions will be evaluated and compared to pre-existing risk prediction scoring tools. Results PERCEIVE launched on 01/10/2020 with 23 centres (16 UK, 7 international) registered to collect data. 50 other centres (27 UK, 23 international) have expressed interest/are pursuing local audit/ethical approval. We aim to collect data on clinicians estimate of outcomes for over 500 patients. Discussion This study will utilise a trainee research network to provide data on the accuracy of healthcare professionals’ predictions of outcomes following MLLA and compare this to the utility of existing prediction tools in this patient cohort.

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