Article

Subjects with lower limb amputation develop new motor control
strategies to preserve balance when they experience unexpected perturbations.
Most studies performed thus far have not aimed to discuss the possible
differences in postural control between subjects with vascular unilateral
transtibial amputation (UTA) and subjects with traumatic UTA. OBJECTIVE: To
analyze the automatic postural reaction in response to unexpected surface
perturbations in a sample of subjects with traumatic and vascular UTA and to
compare these observations with those for a group of healthy subjects. SETTING:
University department. DESIGN: Observational study. PARTICIPANTS: A total of 9
men with traumatic UTA, 7 men with vascular UTA, and 10 control subjects without
amputation. INTERVENTION: Computerized dynamic posturography Smart EquiTest
System version 8.0 was used to measure automatic postural responses in both
groups. MAIN OUTCOME MEASURES: The motor control test was used to assess the
participants' automatic postural responses to unexpected surface perturbations.
RESULTS: Latency scores showed that subjects with traumatic UTA coped with faster
latencies under their sound limb than did the subjects with vascular UTA in
medium backward and forward perturbations (medium-backward: P = .004;
medium-forward: P = .037). In addition, the subjects with traumatic UTA also
managed faster responses to medium-backward (P = .017 versus right control limb;
P = .046 versus left control limb) and large-backward (P = .021 versus right
control limb) and medium-forward (P = .012 versus right control limb; P = .043
versus left control limb) perturbations in their sound limb in contrast to
control subjects. Weight symmetry showed that the subjects with traumatic UTA
bore significantly more weight through their sound limb compared with the control
subjects during medium and large backward translations (P = .028 and P = .045,
respectively). CONCLUSIONS: The subjects with traumatic UTA had a greater
reliance on their sound limb, and they had faster latencies and more weight in
the sound limb upon experiencing unexpected perturbations compared with the
control subjects. Conversely, persons with vascular UTA experienced slower
latency responses in the sound limb compared with persons with traumatic UTA.
CI - Copyright (c) 2016 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS