The Effects of Spinal Stabilization Exercises on the Spatial and Temporal Parameters of Gait in Individuals With Lower Limb Loss

Abstract

In Brief The purpose of this study was to determine whether improvements in the spatial and temporal parameters of gait would be observed after 8-week spinal stabilization training program in individuals with lower limb loss. The study used a repeated measures pretest-posttest design of outcome measures in outpatient community-dwelling adults. Thirty-four individuals with lower limb loss were recruited from three prosthetic facilities located in Nassau County, Long Island, NY. Subjects participated in 8-week spinal stabilization training consisting of six exercises including abdominal bracing, heel slides, marching in place, bent-knee fall-outs, bridging, and quadruped arm/leg lifts. Primary outcome measures of spatial and temporal parameters of gait including base of support (BOS), step length, stride length, velocity, and cadence were determined with the GAITRite system. In addition, the reliability of the GAITRite system for measurement of gait characteristics in individuals with lower limb loss as determined with a test-retest procedure yielded reliability coefficients ranging from 0.884 to 0.977. After spinal stabilization exercise training, based on a paired t-test analysis, there were significant improvements in selected gait parameters including amputated side step length and stride length, sound side stride length, and velocity, whereas changes in sound side step length, amputated and sound side BOS, and cadence were not changed significantly. Except for BOS, there were no differences in gait characteristics between individuals with transfemoral and transtibial amputations after spinal stabilization training as demonstrated by independent t-test analysis. This study suggests that spinal stabilization exercise training may be effective in improving selected spatial and temporal parameters of gait as a part of an overall rehabilitation program in individuals with lower limb loss through strengthening of the core muscles of the trunk, especially the transverse abdominis and multifidus. This study evaluated the effects of an 8-week spinal stabilization training program on the spatial and temporal parameters of gait in individuals with lower limb loss. Amputated side step length, sound and amputated side stride length, and gait velocity were significantly higher after exercise intervention, suggesting that spinal stabilization exercise training may be an effective method of improving gait in this population. The results of this study further suggest that individuals with lower limb loss may benefit from redirecting exercise programs to focus more on core strengthening to improve stability and control of the prosthesis and promote more balanced weight acceptance on the sound and prosthetic limbs.