Postural responses to dynamic perturbations in amputee fallers versus nonfallers: a comparative study with able-bodied subjects

Natalie Vanicek, Siobhan Strike, Lars McNaughton, Remco Polman
Archives of Physical Medicine and Rehabilitation 2009, 90 (6): 1018-25

OBJECTIVES: To quantify postural responses in amputee fallers versus nonfallers by using computerized dynamic posturography.

DESIGN: All participants completed standard protocols on the Sensory Organization Test (SOT) and Motor Control Test (MCT) of the NeuroCom Equitest.

SETTING: Human performance laboratory in a university in the United Kingdom.

PARTICIPANTS: Transtibial amputees (n=9) and able-bodied subjects (n=9) (all categorized into fallers and nonfallers according to their falls history in the previous 9 mo).

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURES: Equilibrium and strategy scores on the SOT. Postural response latency and weight distribution on the MCT.

RESULTS: Equilibrium scores were highest when somatosensory information was accurate, but there were no differences between the groups. Strategy scores were lower when visual cues and somatosensory information were inaccurate, and the fallers and nonfallers used a combination of ankle and hip strategies to prevent a loss of balance. The amputee nonfallers indicated they had a greater reliance on visual input even when it was inaccurate compared with the amputee fallers, whereas the control fallers used the hip strategy significantly more compared with the control nonfallers (SOT condition 6: 56+/-22 vs 72+/-10, P=.01). Weight distribution symmetry showed that the amputee nonfallers bore significantly more weight through their intact limb compared with the amputee fallers during backward and forward translations (P<.05).

CONCLUSIONS: The SOT and MCT appeared to be population specific and therefore did not reliably identify fallers among transtibial amputees or distinguish between community-dwelling control fallers and nonfallers. Amputee and control fallers can prevent a fall during challenging static and dynamic conditions by adapting their neuromuscular responses. The results from this study have important implications for amputee gait rehabilitation, falls prevention, and treatment programs.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"