Postural Control in Response to Altered Sensory Conditions in Persons With Dysvascular and Traumatic Transtibial Amputation

Abstract

ObjectiveTo compare the postural control of persons with a dysvascular transtibial amputation and traumatic transtibial amputation with able-bodied adults with and without a dysvascular condition in altered sensory testing conditions. DesignCross-sectional study. SettingUniversity balance clinic. ParticipantsThe study participants (N=35) included: participants with a dysvascular transtibial amputation (n=9), participants with a traumatic transtibial amputation (n=9), age-matched able-bodied adults without a dysvascular condition (n=9), and able-bodied adults with a dysvascular condition (n=8). InterventionsSix Sensory Organization Test (SOT) conditions, which included standing with eyes open (condition 1) and closed (condition 2) on a static force platform with visual surround; standing with eyes open on a static force platform with movable visual surround (condition 3); standing with eyes open (condition 4) and closed (condition 5) on a movable force platform with static visual surround; and standing with eyes open on a movable force platform with movable visual surround (condition 6). Main Outcome MeasuresBilateral anteroposterior (AP) and mediolateral (ML) center of pressure variables, namely root mean square distance (RMSD) and mean velocity (mVel), for each of the 6 SOT conditions. ResultsThe dysvascular transtibial amputation group demonstrated a higher AP RMSD (P≤.04) on the sound side than did the able-bodied adults without a dysvascular condition and the able-bodied adults with a dysvascular condition in SOT conditions 1 and 2, respectively. Both the dysvascular transtibial amputation group and the traumatic transtibial amputation group demonstrated a higher AP RMSD (P≤.002) than the able-bodied adults without a dysvascular condition in SOT conditions 3 and 4. The dysvascular transtibial amputation group showed higher AP mVel (P≤.002) on the sound side for SOT conditions 2 and 3, whereas both amputation groups showed higher AP mVel for SOT conditions 1 and 4 than the able-bodied adults with and without a dysvascular condition. ConclusionsPostural control of the dysvascular transtibial amputation group was not different than the traumatic transtibial amputation group in challenging sensory conditions. However, when compared with the groups of able-bodied adults with and without a dysvascular condition, postural strategies distinct with amputation etiology were observed.