Margins of stability in young adults with traumatic transtibial amputation walking in destabilizing environments

Eduardo J Beltran; Jonathan B Dingwell; Jason M Wilken

doi:10.1016/j.jbiomech.2013.12.011

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Margins of stability in young adults with traumatic transtibial amputation walking in destabilizing environments

Journal article

Open access

Peer reviewed

Margins of stability in young adults with traumatic transtibial amputation walking in destabilizing environments

Eduardo J Beltran, Jonathan B Dingwell and Jason M Wilken

Journal of biomechanics, Vol.47(5), pp.1138-1143

03/21/2014

DOI: 10.1016/j.jbiomech.2013.12.011

PMCID: PMC4050449

PMID: 24444777

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Abstract

Understanding how lower-limb amputation affects walking stability, specifically in destabilizing environments, is essential for developing effective interventions to prevent falls. This study quantified mediolateral margins of stability (MOS) and MOS sub-components in young individuals with traumatic unilateral transtibial amputation (TTA) and young able-bodied individuals (AB). Thirteen AB and nine TTA completed five 3-minute walking trials in a Computer Assisted Rehabilitation ENvironment (CAREN) system under three each of three test conditions: no perturbations, pseudo-random mediolateral translations of the platform, and pseudo-random mediolateral translations of the visual field. Compared to the unperturbed trials, TTA exhibited increased mean MOS and MOS variability during platform and visual field perturbations (p < 0.010). Also, AB exhibited increased mean MOS during visual field perturbations and increased MOS variability during both platform and visual field perturbations (p < 0.050). During platform perturbations, TTA exhibited significantly greater values than AB for mean MOS (p < 0.050) and MOS variability (p < 0.050); variability of the lateral distance between the center of mass (COM) and base of support at initial contact (p < 0.005); mean and variability of the range of COM motion (p < 0.010); and variability of COM peak velocity (p < 0.050). As determined by mean MOS and MOS variability, young and otherwise healthy individuals with transtibial amputation achieved stability similar to that of their able-bodied counterparts during unperturbed and visually-perturbed walking. However, based on mean and variability of MOS, unilateral transtibial amputation was shown to have affected walking stability during platform perturbations.

transtibial amputation

lateral stability

perturbations

walking

center of mass

Details

Title: Subtitle: Margins of stability in young adults with traumatic transtibial amputation walking in destabilizing environments
Creators: Eduardo J Beltran - Center for the Intrepid, Department of Orthopaedics and Rehabilitation, Brooke Army Medical Center, Ft. Sam Houston, TX 78234, USA
Jonathan B Dingwell - Department of Kinesiology & Health Education, University of Texas, Austin, TX 78712, USA
Jason M Wilken - Center for the Intrepid, Department of Orthopaedics and Rehabilitation, Brooke Army Medical Center, Ft. Sam Houston, TX 78234, USA
Resource Type: Journal article
Publication Details: Journal of biomechanics, Vol.47(5), pp.1138-1143
DOI: 10.1016/j.jbiomech.2013.12.011
PMID: 24444777
PMCID: PMC4050449
NLM abbreviation: J Biomech
ISSN: 0021-9290
eISSN: 1873-2380
Grant note: name: NIH, award: 5R01HD059844
Language: English
Date published: 03/21/2014
Academic Unit: Physical Therapy and Rehabilitation Science
Record Identifier: 9984046934602771

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