This might increase the risk of developing pain symptoms and secondary overuse musculoskeletal injury which has a relatively high incidence in lower limb amputees and restricts their functional mobility. The decreased utilization of the prosthetic leg for posture control is compensated by altered biomechanics of the intact non-amputated limb, pelvis, and trunk. This strategy is even more pronounced in situations with increased demands for postural control. After a TTA, most individuals rely automatically on their intact leg during standing and walking. One of the most obvious compensatory and adaptive postural control strategies in lower limb amputees is the decreased utilization of the leg with the prosthesis than that of the intact leg. The ensuing active muscle power and body mass asymmetry, as well as the deteriorated somatosensory input, must be compensated for by altered balance control strategies. Postural control is compromised in individuals after transtibial amputation (TTA), primarily due to the loss of sensory feedback and muscle control of the amputated leg and decreased range of motion of the prosthetic foot. The current study indicates that decreased utilization of the prosthetic leg in tTTAs represents adaptive postural control strategy, but as prosthesis use duration increased, the engagement of the prosthetic leg improved.Īdequate postural control is necessary to effectively perform everyday activities and to prevent falls. In the tTTA group, the weight-bearing symmetry and the inclination toward the prosthetic leg ( p < 0.05) was positively correlated with prosthesis use duration ( p < 0.05). Compared to the controls, the participants with tTTA bore less weight on the prosthetic leg ( p < 0.001) during the MCT and had reduced inclination toward the prosthetic leg ( p < 0.001) within the LOS. Automatic posture reactions and volitional motion toward given direction using standardized posturographic protocols (NeuroCom) of the Motor Control Test (MCT) and Limits of Stability (LOS) were assessed in eighteen participants with tTTA and eighteen age-matched controls. The aim of this study is to assess automatic and voluntary postural control strategies in individuals with unilateral tTTA compared to those in control subjects and to define the effect of balance-related factors on these strategies. Mechanisms behind compromised balance control in people with transtibial amputation need to be further explored, as currently little is known specifically about postural control strategies in people with traumatic transtibial amputation (tTTA).
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