ArticleJournal of neuroengineering and rehabilitation2021
Dynamic balancing responses in unilateral transtibial amputees following outward-directed perturbations during slow treadmill walking differ considerably for amputated and non-amputated side.
Article in Journal of neuroengineering and rehabilitation, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 19 citations in OpenAlex.
- Above-Knee Amputees' Balance and Recovery Strategies After Mediolateral Perturbations from a Cable-Driven System.Annals of biomedical engineering · 2026Article
- Effects of a Torsion-Adaptive Energy-Storing-and-Return Prosthetic Foot on Balance Control in Individuals with Transtibial Amputation: A Pilot Pre-Post Motion Analysis Study.Bioengineering (Basel, Switzerland) · 2026Article
- Sensory feedback for gait in transtibial amputees: a narrative review of technologies and clinical outcomes.Frontiers in bioengineering and biotechnology · 2025Review
- Cross-step detection using center-of-pressure based algorithm for real-time applications.Journal of neuroengineering and rehabilitation · 2024Article
- Balance confidence classification in people with a lower limb amputation using six minute walk test smartphone sensor signals.PLOS digital health · 2024Article
- A Review of Current State-of-the-Art Control Methods for Lower-Limb Powered Prostheses.Annual reviews in control · 2023Article
- Automated step detection with 6-minute walk test smartphone sensors signals for fall risk classification in lower limb amputees.PLOS digital health · 2022Article
- Amputee Fall Risk Classification Using Machine Learning and Smartphone Sensor Data from 2-Minute and 6-Minute Walk Tests.Sensors (Basel, Switzerland) · 2022Article
- A survey for characterizing details of fall events experienced by lower limb prosthesis users.PloS one · 2022Article
- Postural Control Strategies and Balance-Related Factors in Individuals with Traumatic Transtibial Amputations.Sensors (Basel, Switzerland) · 2021Article
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDue to disrupted motor and proprioceptive function, lower limb amputation imposes considerable challenges associated with balance and greatly increases risk of falling in presence of perturbations during walking. The aim of this study was to investigate dynamic balancing responses in unilateral transtibial amputees when they were subjected to perturbing pushes to the pelvis in outward direction at the time of foot strike on their non-amputated and amputated side during slow walking.
methodsFourteen subjects with unilateral transtibial amputation and nine control subjects participated in the study. They were subjected to perturbations that were delivered to the pelvis at the time of foot strike of either the left or right leg. We recorded trajectories of center of pressure and center of mass, durations of in-stance and stepping periods as well as ground reaction forces. Statistical analysis was performed to determine significant differences in dynamic balancing responses between control subjects and subjects with amputation when subjected to outward-directed perturbation upon entering stance phases on their non-amputated or amputated sides.
resultsWhen outward-directed perturbations were delivered at the time of foot strike of the non-amputated leg, subjects with amputation were able to modulate center of pressure and ground reaction force similarly as control subjects which indicates application of in-stance balancing strategies. On the other hand, there was a complete lack of in-stance response when perturbations were delivered when the amputated leg entered the stance phase. Subjects with amputations instead used the stepping strategy and adjusted placement of the non-amputated leg in the ensuing stance phase to make a cross-step. Such response resulted in significantly larger displacement of center of mass.
conclusionsResults of this study suggest that due to the absence of the COP modulation mechanism, which is normally supplied by ankle motor function, people with unilateral transtibial amputation are compelled to choose the stepping strategy over in-stance strategy when they are subjected to outward-directed perturbation on the amputated side. However, the stepping response is less efficient than in-stance response.
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