Article

Roughly 50% of individuals with lower limb amputation
report a fear of falling and fall at least once a year. Perturbation-based gait
training and the use of virtual environments have been shown independently to be
effective at improving walking stability in patient populations.
An intervention
was developed combining the strengths of the 2 paradigms utilizing continuous,
walking surface angle oscillations within a virtual environment.
This case report
describes walking function and mediolateral stability outcomes of an individual
with a unilateral transfemoral amputation following a novel perturbation-based
gait training intervention in a virtual environment.
CASE DESCRIPTION: The
patient was a 43-year-old male veteran who underwent a right transfemoral
amputation 7+ years previously as a result of a traumatic blast injury. He used a
microprocessor-controlled knee and an energy storage and return foot. OUTCOMES:
Following the intervention, multiple measures indicated improved function and
stability, including faster self-selected walking speed and reduced functional
stepping time, mean step width, and step width variability. These changes were
seen during normal level walking and mediolateral visual field or platform
perturbations. In addition, benefits were retained at least 5 weeks after the
final training session. DISCUSSION: The perturbation-based gait training program
in the virtual environment resulted in the patient's improved walking function
and mediolateral stability. Although the patient had completed intensive
rehabilitation following injury and was fully independent, the intervention still
induced notable improvements to mediolateral stability.
Thus, perturbation-based
gait training in challenging simulated environments shows promise for improving
walking stability and may be beneficial when integrated into a rehabilitation program.
CI - (c) 2016 American Physical Therapy Association.

Langue : ANGLAIS