Selecting a test for the clinical assessment of balance and walking capacity at the definitive fitting state after unilateral amputation: a comparative study

2012 ◽  
Vol 36 (4) ◽  
pp. 415-422 ◽  
Author(s):  
Vincent Gremeaux ◽  
Sabeur Damak ◽  
Odile Troisgros ◽  
Amine Feki ◽  
Davy Laroche ◽  
...  
Keyword(s):  
Lower Limb ◽  
Pearson Correlation ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Clinical Test ◽  
Functional Evaluation ◽  
Score Distribution ◽  
Timed Up And Go ◽  
Walking Capacity ◽  
Functional Reach Test

Background:There is a lack of data and consensus concerning the most appropriate functional evaluation in clinical practice at the definitive prosthetic phase after lower limb amputation.Objectives:To determine among several selected functional tests the most pertinent to evaluate balance and prosthetic walking.Study Design:Validation of a diagnostic procedure.Methods:Sixty-four patients were included. Outcome measures: Timed Up and Go test, Functional Reach test (FRT), one-leg balance, tandem test, Modified Houghton Scale, Berg Balance Scale, two-minute walk test (2MW test). Correlations were assessed with the Pearson correlation coefficient and the Principal Component Analysis. Score distribution was analyzed with the Shapiro-Wilk W normality test. Receiver operating characteristic curves were drawn to identify the best predictor for the function.Results:The clinical tests correlated highly with each other. Only 2MW test and FRT did not have either a floor/ceiling effect, or a bi-modal distribution. The 2MW test was the best predictor of prosthetic walking limitations (area under the curve 0.93 (0.83–0.97), the best threshold was between 130 and 150 meters), and FRT was best for balance.Conclusions:2MW test can be proposed as the first-line clinical test. The FRT can be indicated for the specific assessment of balance disorders.Clinical relevanceThis validation of a clinical evaluation of balance and walking capacity after lower limb amputation may be useful in everyday practice to ensure in a simple and standardized way the follow-up of patients and adapt treatments – especially prosthetics – at the definitive prosthetic phase.

scholarly journals The Relationship Between Vestibular Sensory Integration and Prosthetic Mobility in Community Ambulators With Unilateral Lower Limb Amputation

2020 ◽  
Author(s):  
Jennifer Lučarević ◽  
Ignacio Gaunaurd ◽  
Sheila Clemens ◽  
Paulina Belsky ◽  
Lauren Summerton ◽  
...  
Keyword(s):  
Lower Limb ◽  
Sensory Integration ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Clinical Test ◽  
Timed Up And Go ◽  
Convenience Sample ◽  
The Relationship ◽  
Step Turn ◽  
Degree Step

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.

The timed “up and go” test: Reliability and validity in persons with unilateral lower limb amputation

1999 ◽  
Vol 80 (7) ◽  
pp. 825-828 ◽  
Author(s):  
Tanneke Schoppen ◽  
Annemarijke Boonstra ◽  
Johan W. Groothoff ◽  
Jaap de Vries ◽  
Ludwig N.H. Göeken ◽  
...  
Keyword(s):  
Lower Limb ◽  
Reliability And Validity ◽  
Lower Limb Amputation ◽  
Test Reliability ◽  
Limb Amputation ◽  
Timed Up And Go

Preoperative characteristics and functional outcomes of lower limb amputees treated at Southern Älvsborg Hospital, Sweden

2013 ◽  
Vol 37 (4) ◽  
pp. 298-304 ◽  
Author(s):  
Maria Glemne ◽  
Nerrolyn Ramstrand ◽  
Jessica Crafoord ◽  
Linus Nygren
Keyword(s):  
Lower Limb ◽  
Functional Outcomes ◽  
Daily Practice ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Clinical Practices ◽  
Timed Up And Go ◽  
Significant Difference ◽  
Research Findings ◽  
Lower Limb Amputees

Background:Within the prosthetics profession, there is a lack of evidence to support many clinical practices. It is therefore important that clinicians systematically document and evaluate their daily practices.Objectives:To record preoperative characteristics and functional outcomes for patients with a lower limb amputation and to investigate variations between prosthetic users and non-prosthetic users.Study Design:Prospective cohort study.Methods:A total of 23 patients (mean age = 80 years, standard deviation = 7.3) who underwent a major lower limb amputation were assessed within 2 weeks of admission and 6 months post-operatively. Locomotor Capabilities Index-5, the Timed-Up-and-Go Test and prosthetic use were used to evaluate functional outcomes.Results:A total of 13 participants (57%) received a prosthesis within 6 months of amputation. Mean time to prosthetic fitting was 48 days (range = 28–97). No statistically significant difference was found between prosthetic users and non-prosthetic users regarding age, time to rehabilitation and Locomotor Capabilities Index-5 (p > 0.05). Locomotor Capabilities Index-5 basic was significantly lower at 6 months than prior to amputation (p = 0.039).Conclusion:The functional outcome at 6 months indicates a sizable restriction in mobility among lower limb amputees. No variation in preoperative characteristics between prosthetic users and non-prosthetic users could be confirmed in this study.Clinical relevanceThis study highlights the need for prosthetists to better incorporate research findings into their daily practice and presents an example of how to implement a procedure for assessment and documentation of patients’ functional outcomes in a clinical setting. Results confirm difficulties in identifying amputees who will become prosthetic users based on preoperative characteristics.

scholarly journals ESTABLISHING THE RELIABILITY AND VALIDITY OF THE COMPONENT TIMED-UP-AND-GO TEST TO DETERMINE BASIC PROSTHETIC MOBILITY IN PEOPLE WITH LOWER LIMB AMPUTATION

2018 ◽  
Author(s):  
Sheila Clemens ◽  
Ignacio Gaunaurd ◽  
Jennifer Lucarevic ◽  
Glenn Klute ◽  
Neva Kirk-Sanchez ◽  
...  
Keyword(s):  
Lower Limb ◽  
Convergent Validity ◽  
Reliability And Validity ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Timed Up And Go ◽  
National Assembly ◽  
Sit To Stand ◽  
Time Required ◽  
Test Retest Reliability

INTRODUCTION Studies suggest that brief bouts of activity consisting of sit-to-stand transitions, gait initiation, turning and negotiation of obstacles, are essential tasks of daily mobility, as well as prosthetic mobility1,2. Using outcome measures deemed reliable for use in the amputee population is ideal3,4. The purpose of this study was to investigate the reliability and validity of a component timed-up-and-go test (cTUG), using a mobile application (App), to evaluate basic prosthetic mobility tasks in people with lower limb amputation (LLA). The cTUG captures time required to perform the subtask components of sit to stand transitions, linear gait, and a 180˚ turn that are requisites of the standard TUG test. It was hypothesized that the cTUG would demonstrate test-retest reliability, differentiate between groups based on anatomical level of amputation, and exhibit convergent validity with other measures of prosthetic mobility and balance. Abstract PDF  Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/32036/24452 How to cite: Clemens S, Gaunaurd I, Lucarevic J, Klute G, Kirk-Sanchez N, Bennett C, Gailey R. ESTABLISHING THE RELIABILITY AND VALIDITY OF THE COMPONENT TIMED-UP-AND-GO TEST TO DETERMINE BASIC PROSTHETIC MOBILITY IN PEOPLE WITH LOWER LIMB AMPUTATION. CANADIAN PROSTHETICS & ORTHOTICS JOURNAL, VOLUME 1, ISSUE 2, 2018; ABSTRACT, ORAL PRESENTATION AT THE AOPA’S 101ST NATIONAL ASSEMBLY, SEPT. 26-29, VANCOUVER, CANADA, 2018. DOI: https://doi.org/10.33137/cpoj.v1i2.32036 Abstracts were Peer-reviewed by the AOPA 2018 National Assembly Scientific Committee. 

Patient satisfaction following lower-limb amputation: the role of gait deviation

2011 ◽  
Vol 35 (2) ◽  
pp. 225-233 ◽  
Author(s):  
Lauren Kark ◽  
Anne Simmons
Keyword(s):  
Patient Satisfaction ◽  
Lower Limb ◽  
Functional Ability ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Timed Up And Go ◽  
Cross Sectional ◽  
High Functioning ◽  
Satisfaction Measures

Background: Patient satisfaction is an important measurement in healthcare for administrators, clinicians and patients.Objectives: This study investigated the role of gait deviation in patient satisfaction following lower-limb amputation and prosthesis prescription.Study design: A cross-sectional study was done.Methods: Twenty community-based unilateral lower-limb amputees, 12 transtibial and 8 transfemoral, were recruited from support groups. Participants completed the prosthesis evaluation questionnaire (PEQ) with embedded satisfaction-related questions, the timed-up-and-go test and the six-minute walk test, and also underwent quantitative three-dimensional analysis. Kinematic deviation was summarized using the gait profile score (GPS).Results: Satisfaction levels were generally high (median 80 + /100). Sociodemographic variables did not correlate significantly with any of the satisfaction measures (−0.35 ≤  r ≤ 0.54). Satisfaction correlated strongly with the PEQ scales, particularly ambulation, prosthetic utility, frustration, perceived response and social burden ( r ≥ 0.70). By contrast, the relationships between satisfaction and performance-based outcome measures were not significant (−0.45 ≤  r ≤ 0.43), and the GPS did not correlate with any satisfaction measures (−0.23 ≤  r ≤ 0.15).Conclusions: In this study of high functioning amputees, gait deviation was unimportant to the amputee, while self-reported functional ability and attitudes toward the prosthesis were the strongest correlates of satisfaction following lower-limb amputation.Clinical relevance For the high functioning individuals with lower-limb amputation in this study, gait deviation was not a significant correlate of patient satisfaction. Results suggest that improving self-perceived functional ability and attitudes toward the prosthesis, rather than minimizing gait deviation, will improve patient satisfaction.

A randomized controlled trial to evaluate the feasibility of the Wii Fit for improving walking in older adults with lower limb amputation

2016 ◽  
Vol 31 (1) ◽  
pp. 82-92 ◽  
Author(s):  
Bita Imam ◽  
William C Miller ◽  
Heather Finlayson ◽  
Janice J Eng ◽  
Tal Jarus
Keyword(s):  
Lower Limb ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Walk Test ◽  
Wii Fit ◽  
Randomized Controlled ◽  
End Of Treatment ◽  
Perceived Benefit ◽  
Walking Capacity ◽  
Minute Walk

Objective: To assess the feasibility of Wii.n.Walk for improving walking capacity in older adults with lower limb amputation. Design: A parallel, evaluator-blind randomized controlled feasibility trial. Setting: Community-living. Participants: Individuals who were ⩾50 years old with a unilateral lower limb amputation. Intervention: Wii.n.Walk consisted of Wii Fit training, 3x/week (40 minute sessions), for 4 weeks. Training started in the clinic in groups of 3 and graduated to unsupervised home training. Control group were trained using cognitive games. Main Measures: Feasibility indicators: trial process (recruitment, retention, participants’ perceived benefit from the Wii.n.Walk intervention measured by exit questionnaire), resources (adherence), management (participant processing, blinding), and treatment (adverse event, and Cohen’s d effect size and variance). Primary clinical outcome: walking capacity measured using the 2 Minute Walk Test at baseline, end of treatment, and 3-week retention. Results: Of 28 randomized participants, 24 completed the trial (12/arm). Median (range) age was 62.0 (50-78) years. Mean (SD) score for perceived benefit from the Wii.n.Walk intervention was 38.9/45 (6.8). Adherence was 83.4%. The effect sizes for the 2 Minute Walk Test were 0.5 (end of treatment) and 0.6 (3-week retention) based on intention to treat with imputed data; and 0.9 (end of treatment) and 1.2 (3-week retention) based on per protocol analysis. The required sample size for a future larger RCT was deemed to be 72 (36 per arm). Conclusions: The results suggested the feasibility of the Wii.n.Walk with a medium effect size for improving walking capacity. Future larger randomized controlled trials investigating efficacy are warranted.

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