Effect of Free Swing Gait Training on Back Pain in a Patient with Bilateral Lower Extremity Amputations: A Case Report

Abstract

Introduction: Back pain is a common occurrence in persons with a lower extremity amputation, and can cause a chronic disability. Early physical therapy interventions of gait training with prosthesis could prevent amputees from becoming disabled by chronic back pain. Free swing gait training is sometimes utilized in physical therapy with transfemoral amputees learning to use prosthesis. However, there is a lack of evidence for the benefits of free swing gait training on decreasing back pain. The purpose of this study is to describe the effect of free swing gait training on low back pain in an amputee. Case Description: The patient was a 57 year old Caucasian male with a history of a left transtibial amputation and a recent right transfemoral amputation. He was referred to physical therapy to learn how to utilize his new transfemoral prosthetic and find functional independence as a bilateral amputee. One of his chief complaints was debilitating low back pain that had increased since his latest amputation. Intervention: Physical therapy intervention included free swing gait training intended to normalize the patient’s gait pattern while ambulating with a left transfemoral and a right transtibial prostheses. It was hypothesized that the normalization of the patient’s gait pattern would decrease his complaint of back pain. Results: After 8 weeks of physical therapy, including 3 weeks of free swing gait training, the patient demonstrated decreased low back pain, increased strength, and improved gait quality and distance. Discussion: The results of this case report demonstrate that the use of free swing gait training can be beneficial to decrease back pain in a bilateral amputee.