DIFFERENCES IN HIP MUSCLE STRENGTH AND STATIC BALANCE IN PATIENTS WITH TRANSFEMORAL AMPUTATIONS CLASSIFIED AT DIFFERENT K-LEVELS: A PRELIMINARY CROSS-SECTIONAL STUDY

BACKGROUND: Following amputation, patients with lower limb amputations (LLA) are classified into different functional mobility levels (K-levels) ranging from K0 (lowest) to K4 (highest). However, K-level classification is often based on subjective criteria. Objective measures that are able to differentiate between K-levels can help to enhance the objectivity of K-level classification. OBJECTIVE(S): The goal of this preliminary cross-sectional study was to investigate whether differences in hip muscle strength and balance parameters exist among patients with transfemoral amputations (TFA) assigned to different K-levels. METHODOLOGY: Twenty-two participants with unilateral TFA were recruited for this study, with four participants assigned to K1 or K2, six assigned to K3 and twelve assigned to K4. Maximum isometric hip strength of the residual limb was assessed in hip flexion, abduction, extension, and adduction using a custom-made diagnostic device. Static balance was investigated in the bipedal stance on a force plate in eyes open (EO) and eyes closed (EC) conditions. Kruskal-Wallis tests were used to evaluate differences between K-level groups. FINDINGS: Statistical analyses revealed no significant differences in the parameters between the three K-level groups (p>0.05). Descriptive analysis showed that all hip strength parameters differed among K-level groups showing an increase in maximum hip torque from K1/2-classified participants to those classified as K4. Group differences were also present in all balance parameters. Increased sway was observed in the K1/2 group compared to the K4 group, especially for the EC condition. CONCLUSION: Although not statistically significant, the magnitude of the differences indicates a distinction between K-level groups. These results suggest that residual limb strength and balance parameters may have the potential to be used as objective measures to assist K-level assignment for patients with TFA. This potential needs to be confirmed in future studies with a larger number of participants. Layman's Abstract Patients with lower limb amputation (LLA) are classified into different mobility levels, so-called K-levels, which are ranging from K0 (lowest) to K4 (highest). K-level classification is relevant for the patients as it determines the type of prosthetic components available. However, K-level can vary greatly based on the clinician or orthopedic technician individual assessment. Objective data from physical performance tests can help to improve K-level classification. Therefore, muscle strength tests of the amputation stump as well as balance tests were performed in this study to determine whether these parameters have the potential to support K-level classification. Twenty-two participants with a thigh amputation participated in the study (four K1/2-, six K3- and twelve K4-participants). Hip muscle strength on the amputation side was assessed as well as static balance in the double leg stance with eyes open and eyes closed. Analysis of the data showed that all hip strength parameters differed between the K-level groups, with maximum strength increasing from the K1/2 group to the K4 group. Group differences were also seen in the balance parameters with greater body sway for the K1/2 group when compared to the K4 group, especially when participants had their eyes closed. These results show that muscle strength tests of the residual limb and static balance tests may serve as additional measures to improve K-level assignment for patients with LLA. This was only an initial study and further studies with a larger number of participants are required to confirm these results. Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/37456/28905 How To Cite: John S, Orlowski K, Mrkor K.U, Edelmann-Nusser J, Witte K. Differences in hip muscle strength and static balance in patients with transfemoral amputations classified at different K-levels: A preliminary cross-sectional study. Canadian Prosthetics & Orthotics Journal. 2022; Volume 5, Issue 1, No.5. https://doi.org/10.33137/cpoj.v5i1.37456 Corresponding Author: Stefanie John,Department of Sports Science, Faculty of Humanities, Otto von Guericke University, Magdeburg, Germany.E-Mail: [email protected] ID: https://orcid.org/0000-0001-6722-7195

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The Gait Deviation Index Is Associated with Hip Muscle Strength and Patient-Reported Outcome in Patients with Severe Hip Osteoarthritis—A Cross-Sectional Study

PLoS ONE ◽

10.1371/journal.pone.0153177 ◽

2016 ◽

Vol 11 (4) ◽

pp. e0153177 ◽

Cited By ~ 18

Author(s):

Signe Rosenlund ◽

Anders Holsgaard-Larsen ◽

Søren Overgaard ◽

Carsten Jensen

Keyword(s):

Muscle Strength ◽

Hip Osteoarthritis ◽

Cross Sectional Study ◽

Patient Reported Outcome ◽

Sectional Study ◽

Cross Sectional ◽

Deviation Index ◽

Hip Muscle ◽

Patient Reported ◽

Gait Deviation Index

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Association between severity of hip chondrolabral injuries, dynamic hip muscle strength and quality of life: A cross-sectional study in patients with femoroacetabular impingement syndrome scheduled for hip arthroscopy

Clinical Biomechanics ◽

10.1016/j.clinbiomech.2021.105348 ◽

2021 ◽

Vol 84 ◽

pp. 105348

Author(s):

Diogo Gomes ◽

Daniel C. Ribeiro ◽

Richard P. Canella ◽

Taylor Ferreira ◽

Guilherme V. da Costa ◽

...

Keyword(s):

Quality Of Life ◽

Muscle Strength ◽

Femoroacetabular Impingement ◽

Hip Arthroscopy ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Hip Muscle ◽

Femoroacetabular Impingement Syndrome

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Hip Muscle Strength, Dynamic Balance and Functional Capacity of Community-Dwelling Older Adults Aged 60 and Older: A Cross-Sectional Study

Journal of Biomechanics ◽

10.1016/j.jbiomech.2021.110753 ◽

2021 ◽

pp. 110753

Author(s):

Flávio Tavares Vieira ◽

Jaqueline Mello Porto ◽

Pâmela Precinotto Martins ◽

Luana Letícia Capato ◽

Fernanda Saori Suetake ◽

...

Keyword(s):

Older Adults ◽

Muscle Strength ◽

Functional Capacity ◽

Dynamic Balance ◽

Cross Sectional Study ◽

Community Dwelling ◽

Sectional Study ◽

Cross Sectional ◽

Hip Muscle ◽

Community Dwelling Older Adults

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Hip muscle strength is decreased in middle-aged recreational male athletes with midportion Achilles tendinopathy: A cross-sectional study

Physical Therapy in Sport ◽

10.1016/j.ptsp.2016.09.008 ◽

2017 ◽

Vol 25 ◽

pp. 55-61 ◽

Cited By ~ 9

Author(s):

B. Habets ◽

H.W. Smits ◽

F.J.G. Backx ◽

R.E.H. van Cingel ◽

B.M.A. Huisstede

Keyword(s):

Muscle Strength ◽

Cross Sectional Study ◽

Achilles Tendinopathy ◽

Sectional Study ◽

Middle Aged ◽

Cross Sectional ◽

Male Athletes ◽

Hip Muscle

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Using Accelerometers to Record Postural Sway in Adolescents With Concussion: A Cross-Sectional Study

Journal of Athletic Training ◽

10.4085/1062-6050-518-17 ◽

2018 ◽

Vol 53 (12) ◽

pp. 1166-1172 ◽

Cited By ~ 3

Author(s):

Abdulaziz A. Alkathiry ◽

Patrick J. Sparto ◽

Brin Freund ◽

Susan L. Whitney ◽

Anne Mucha ◽

...

Keyword(s):

Postural Sway ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Eyes Closed ◽

Lower Back ◽

Input Type ◽

Eyes Open ◽

Clinical Environments ◽

Anterior Posterior

Objective To investigate the magnitude of postural sway induced by different balance tasks in adolescents with concussion and to examine the associations of postural sway with concussion symptoms. Design Cross-sectional study. Patients or Other Participants Fifty-six adolescents (20 girls, 36 boys) between 13 and 17 years of age who sustained a concussion within the past 44 days and were still symptomatic. Main Outcome Measure(s) Anterior-posterior postural sway was measured using an accelerometer attached to the participant's lower back while he or she performed 6 static-balance tasks that varied the visual input, type of surface, and foot stance. Participants self-reported symptoms that occurred at the time of the concussion (eg, dizziness, confusion, amnesia) as well as at the time of balance testing (eg, eye and head movement–induced dizziness). Results The normalized path length of postural sway during the different balance tasks was greater with the eyes closed (mean = 19.3 mG/s) compared with the eyes open (mean = 12.4 mG/s; P < .001). Furthermore, sway while standing with the feet together on a foam surface (mean = 17.9 mG/s) or while tandem standing on a firm surface (mean = 19.4 mG/s) was greater than sway while standing with the feet together on a firm surface (mean = 10.3 mG/s; P < .001). Greater sway was associated with dizziness and confusion reported at the time of injury (P < .05). Dizziness and headache symptoms at rest were positively correlated with sway (P < .05). Conclusions Using accelerometers to measure postural sway during different challenging balance conditions in adolescents with concussion may provide an objective means of quantifying balance impairments in clinical environments. Furthermore, the association of these measurements with symptoms suggests a need to account for symptom severity at the time of testing.

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Maximal hip muscle strength and rate of torque development 6-30 months after hip arthroscopy for femoroacetabular impingement syndrome: A cross-sectional study

Journal of Science and Medicine in Sport ◽

10.1016/j.jsams.2021.05.006 ◽

2021 ◽

Author(s):

Lasse Ishøi ◽

Kristian Thorborg ◽

Joanne L. Kemp ◽

Michael P. Reiman ◽

Per Hölmich

Keyword(s):

Muscle Strength ◽

Femoroacetabular Impingement ◽

Hip Arthroscopy ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Rate Of Torque Development ◽

Hip Muscle ◽

Femoroacetabular Impingement Syndrome ◽

Torque Development

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Increased modifiable cardiovascular risk factors in patients with Takayasu arteritis: a multicenter cross-sectional study

Advances in Rheumatology ◽

10.1186/s42358-020-00157-1 ◽

2021 ◽

Vol 61 (1) ◽

Author(s):

Alexandre Moura dos Santos ◽

Rafael Giovani Misse ◽

Isabela Bruna Pires Borges ◽

Bruno Gualano ◽

Alexandre Wagner Silva de Souza ◽

...

Keyword(s):

Quality Of Life ◽

Risk Factors ◽

Muscle Strength ◽

Aerobic Capacity ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Metabolic Equivalent ◽

Handgrip Test

Abstract Background Modifiable cardiovascular risk factors (MCRFs), such as those related to aerobic capacity, muscle strength, physical activity, and body composition, have been poorly studied in Takayasu arteritis (TAK). Therefore, the aim of the study was to investigate MCRFs and their relationships with disease status and comorbidities among patients with TAK. Methods A multicenter cross-sectional study was conducted between 2019 and 2020, in which 20 adult women with TAK were compared with 16 healthy controls matched by gender, age, and body mass index. The following parameters were analyzed: aerobic capacity by cardiopulmonary test; muscle function by timed-stands test, timed up-and-go test, and handgrip test; muscle strength by one-repetition maximum test and handgrip test; body composition by densitometry; physical activity and metabolic equivalent by IPAQ, quality of life by HAQ and SF-36; disease activity by ITAS2010 and NIH score; and presence of comorbidities. Results Patients with TAK had a mean age of 41.5 (38.0–46.3) years, disease duration of 16.0 (9.5–20.0) years, and a mean BMI of 27.7±4.5 kg/m2. Three out of the 20 patients with TAK had active disease. Regarding comorbidities, 16 patients had systemic arterial hypertension, 11 had dyslipidemia, and two had type 2 diabetes mellitus, while the control group had no comorbidities. TAK had a significant reduction in aerobic capacity (absolute and relative VO2 peak), muscle strength in the lower limbs, increased visceral adipose tissue, waist-to-hip ratio, reduced walking capacity, decreased weekly metabolic equivalent, and quality of life (P< 0.05) as compared to controls. However, there were no correlations between these MCRFs parameters and disease activity. Conclusions TAK show impairment in MCRFs; therefore, strategies able to improve MCRF should be considered in this disease.

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