Abstract
Lower limb amputation highly impacts the lives of individuals. The inability to walk due to difficulties in adapting to wearing prosthesis can potentially result in physical degeneration and comorbidity in this population. In this randomized clinical trial study, we investigated if a low-cost and easily implementable physiotherapy intervention was effective in improving gait performance and adaptation to lower limb prosthesis in individuals with an amputation. A total of 26 individuals participated in the study, 16 with lower limb amputation and 10 without amputation. Participants with amputation were further divided in intervention and control groups. The intervention group underwent a rehabilitation protocol aimed at strengthening muscles and improving prosthesis adaptation. Muscle strengthening targeted the hip segment, prioritizing the abdominal muscles, hip flexors, extensors, adductors and abductors, followed by cicatricial mobilization and weight-bearing on the stump for desensitization. Assessment and measures were performed across the kinetic and kinematic parameters of gait. In the comparison between pre-and post-intervention, a significant increase in gait speed (0.68—2.98, 95% CI, 1.83, effect size ES) and cadence (0.56—2.69, 95% CI, 1.63, ES) was found between groups and time points. Step (0.73—3.11, 95% CI, 1.92, ES) and stride length (0.62—2.84, 95% CI, 1.73) increased between pre- and post-intervention, while in the control group both variables remained smaller. The intervention group decreased stance phase as a percentage of gait cycle between pre- and post-intervention (− 1.33—0.62, 95% CI, − 36, ES), while it increased in the control group. Improvement in a combination of important gait parameters indicates that the intervention protocol promoted the adaptation to prosthesis and the functional independence of individuals with lower limb amputation. It is recommended that the participants continue receiving follow-up assessments and rehabilitation interventions.
Highlights
Lower limb amputation highly impacts the lives of individuals
Despite not being the only contributor, the inability to walk due to difficulties in adapting to wearing prosthesis can potentially result in physical degeneration and comorbidity in this p opulation[2,3]
For the intervention and control groups at the start of the experiment before intervention, no statistical difference was found for age, height, body mass index, amputation time, cause of amputation and type of amputation
Summary
The inability to walk due to difficulties in adapting to wearing prosthesis can potentially result in physical degeneration and comorbidity in this population. In this randomized clinical trial study, we investigated if a low-cost and implementable physiotherapy intervention was effective in improving gait performance and adaptation to lower limb prosthesis in individuals with an amputation. Improvement in a combination of important gait parameters indicates that the intervention protocol promoted the adaptation to prosthesis and the functional independence of individuals with lower limb amputation. According to a systematic review about physiotherapy rehabilitation programs for individuals with amputations wearing prosthesis, there is no consensus regarding the types and quality of exercises and evaluations more suitable for this population. Among the different types of assessment, temporal-spatial, kinetic and kinematic analyses offer a quantitative approach that can precisely detect differences in p erformance[9,10,11,12]
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