Proprioception in Above-the-Knee Amputees with Artificial Limbs

E P Latanioti,A G Angoules,E C Boutsikari

doi:10.1155/2013/417982

Abstract

Purpose. To evaluate the lower limb proprioceptive sensation in patients with femoral amputation who received an artificial joint. Materials and Methods. 22 patients (18 men, 4 women), 24–65 years old (mean: 42), who had undergone above-the-knee joint amputation and underwent evaluation of proprioception using joint reposition in a predetermined angle of 15° knee flexion. The measurements were applied using a conventional goniometer to both amputated and healthy knees. The last ones were used as internal control. All patients performed an active knee flexion from hyperextension to 15° in a closed kinetic chain in order to evaluate proprioceptive sensation of the knee joint using the joint position sense (JPS) method during specific controllable circumstances very close to normal gait. Results. JPS at 15° flexion for the amputated knee was calculated to be equal to 13.91 (SD = ±4.74), and for the healthy side it was equal to 14.15 (SD = ±2.61). No statistically significant differences were detected between the amputated and the healthy limb (P > 0.05). Conclusions. The proprioceptive information of the stumps did not appear to be affected significantly after thigh amputation and application of artificial prosthesis when JPS at 15° was evaluated. It seems that these patients compensate the loss of the knee sensory receptors via alternative mechanisms.

Highlights

Amputation of lower limb causes a series of changes and concomitant adjustments which are related to the mutilated limb and to the entire body [1,2,3,4]
Statistically significant differences were not recorded in the measured values between the two prevailing those of prosthesis fitted in the study participants (t = −0.942, P > 0.05)
We studied the proprioceptive sensation of the lower limb, with the active reproduction of a predetermined angle method, in a closed kinetic chain environment, using the healthy limb like an internal control group

Summary

Introduction

Amputation of lower limb causes a series of changes and concomitant adjustments which are related to the mutilated limb and to the entire body [1,2,3,4]. The sensorimotor system with its complex mechanisms includes the term of proprioception according to an earlier definition. This intricate process involves the transport of information to the central nervous system, relative to the sense of joint position in space, the feeling of power that develops in the joint (sense of force) through specialized sensory receptors, and kinesthesia, videlicet the sense of motion of the joint [6,7,8]. Above-knee amputations result in a loss of a significant number of mechanoreceptors of the knee and generally of the lower limb [9], a fact that leads to proprioceptive deficits. The reduced proprioceptive ability is recorded as a reduced kinesthesia both in the stump and the contralateral nonamputated lower limb [10]

Methods

Results

Conclusion