Potential and Limitations of Feedback-Supported Gait Retraining in Users of Lower Limb Prostheses

Kaitlyn Rayl,Goeran Fiedler

doi:10.3390/prosthesis3020018

Abstract

The outcomes of prosthetic rehabilitation after lower limb loss are, in large part, affected by the effectiveness of the provided gait retraining. The noted prevalence of adverse long-term effects, such as further joint and muscle degeneration, suggests that traditional rehabilitation programs have limitations. Recent advances in technology and in the understanding of motor learning promise the potential for better gait retraining interventions. This article reviews current literature on systems and methodologies of improving gait parameters in those with lower limb prostheses via exercise programs and various biofeedback systems. A total of 13 articles were included in the qualitative analysis. Findings indicate that many of the investigated systems are able to effectively analyze and change gait in the target population, but there remain considerable gaps in the knowledge. It has been noted that feedback modalities and dosage must be customized based on patient characteristics and rehabilitation goals, yet there is currently not enough published evidence to inform such customization.

Highlights

Introduction in Users of Lower LimbProstheses.Limb loss is a change in one’s physical body, but a life-altering event that can affect a person’s social, emotional, and mental aspects of their life as well
It has been noted that feedback modalities and dosage must be customized based on patient characteristics and rehabilitation goals, yet there is currently not enough published evidence to inform such customization
An estimated 2 million people in the United States are living with limb loss, a number that is predicted to reach 3.6 million by 2050 [1]

Summary

Introduction

Introduction in Users of Lower LimbProstheses.Limb loss is a change in one’s physical body, but a life-altering event that can affect a person’s social, emotional, and mental aspects of their life as well. An estimated 2 million people in the United States are living with limb loss, a number that is predicted to reach 3.6 million by 2050 [1]. The typical rehabilitation process following lower limb loss, including the prescription and fitting of prosthetic devices, has been refined through, among other things, Clinical Practice Guidelines by the Department of Veterans Affairs and Department of Defense [2]. These Practice Guidelines outline the phases of rehabilitation, a multidisciplinary approach, and recommend a continuum of lifelong care following amputation

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Conclusion