Abstract
BackgroundAchieving independent upright posture has known to be one of the main goals in rehabilitation following lower limb amputation. The purpose of this study was to compare postural steadiness of below knee amputees with visual alterations while wearing three different prosthetic feet.MethodsTen male below-knee amputees were instructed to stand quietly on the Biodex® balance platform while wearing solid ankle cushion heel (SACH), single axis (SA) and energy storage and release (ESAR) prosthetic foot under different visual input conditions (eyes-opened and eyes-closed). The overall stability index (OSI), anterior- posterior stability index (APSI), and medial-lateral stability index (MLSI) were computed. Perceived balance assessment of each foot was evaluated using Activities-specific Balance Confidence (ABC) score.ResultsThe findings highlights that SACH showed lowest overall stability index (indicating less body sway) during eyes-opened (OSI: SACH = 1.09, SA = 1.58, ESAR = 1.59) and SA showed lowest overall stability index during eyes-closed (OSI: SACH = 2.52, SA = 2.30, ESAR = 2.76) condition. However, overall stability indexes between foot types did not differ significantly during eyes-opened or eyes-closed (p = 0.651). There was a trend of instability which occurred more in medial-lateral compared to anterior-posterior direction for all foot types, with significant result in ESAR foot(eyes-opened: MLSI = 1.59, APSI = 0.65, p = 0.034; eyes-closed: MLSI = 2.76, APSI = 1.80, p = 0.017, respectively). When comparing between visual conditions, stability score was significantly higher during eyes-closed compared to eyes-opened situations for SACH and ESAR foot (eyes-closed vs opened; SACH OSI: 3.43 vs 1.71, p = 0.018 and MLSI: 3.43 vs 1.71, p = 0.018; ESAR OSI: 3.58 vs 1.86, p = 0.043 and APSI: 1.80 vs 0.65, p = 0.027).ConclusionsThe results of this study suggested postural steadiness in below-knee amputees was not affected by the types of prosthetic foot during quiet upright standing, but was significantly affected when visual cues was absent.
Highlights
Achieving independent upright posture has known to be one of the main goals in rehabilitation following lower limb amputation
Due to the important role of visual information, postural stability assessment with eyes-closed condition is necessary to determining the utilization of other sources of sensory information during postural control in addition to the eyes-open condition which serves as baseline clinical assessment [6]
The Berg balance score indicated that all participants have a low risk of falling
Summary
Achieving independent upright posture has known to be one of the main goals in rehabilitation following lower limb amputation. It is a complex task that integrates somatosensory (proprioceptive, cutaneous and joint), visual and vestibular inputs along with motor coordination to maintain the center of mass (CoM) within the base of support [2,3,4]. Any deficits in these components will result in poor control of body posture, which is often associated with the risk of falling and has been identified as a major health problem [5]. Previous study showed that the absence of visual input will increase the postural sway and asymmetry of stance in below-knee amputees [7]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
