Article

Falls are a common and potentially dangerous event, especially in amputees. In
this study, we compared the mechanisms of balance recovery of 17 unilateral
transtibial amputees and 17 matched able-bodied controls after being released
from a forward-inclined orientation of 10%. Kinematic analysis revealed
statistically significant differences in response time and knee flexion at
heel-strike between both groups. However, there were no statistically significant
differences in step length of the leading and trailing limb, swing time of the
leading limb, and maximal knee flexion during swing. In the amputees, we found
spatial and temporal differences when recovering with the sound versus prosthetic
limb first. When leading with the prosthetic limb, they responded faster and also
the interval between heel-strike of the leading and trailing limb was shorter.
Furthermore, amputees made a longer step and showed less knee flexion at
heel-strike when leading with the prosthetic limb. Interestingly, amputees as a
group had no specific limb preference, prosthetic or sound, to recover after a
forward fall, despite the asymmetry in their locomotor system. Analyses of
dynamic stability (extrapolated center of mass) revealed that the amputees were
equally efficient in recovering from an impending fall as controls, irrespective
whether they lead with their prosthetic or sound limb. We suggest that in amputee
rehabilitation, balance recovery after a fall should be trained with both sides,
as this can increase confidence in fall-prone situations.
CI - Copyright (c) 2010 Elsevier B.V. All rights reserved.

Langue : ANGLAIS