Comparison of trauma and diabetes mellitus-induced transtibial amputees in terms of gait parameters and functional capacity.

backgroundThe aim of this study was to compare gait parameters, balance, weight-bearing symmetry, functional capacity, functional mobility, prosthesis satisfaction, and quality of life between individuals with diabetes mellitus-induced and traumatic transtibial amputations (TTAs).

methodsTen individuals with traumatic transtibial amputation and 10 individuals with diabetes mellitus-induced transtibial amputation were included in the study. All participants in both the trauma and diabetes groups used a vacuum-assisted suction suspension system (VASS) and a carbon composite foot transtibial prosthesis. Gait analysis and weight-bearing symmetry were assessed using a computerized gait analysis system. Balance was evaluated with the Biodex Balance System (BBS), functional capacity with the Six-Minute Walk Test (6MWT), functional mobility with the Timed Up and Go Test (TUG) and the Stair Climbing Test (SCT), prosthesis satisfaction with the Trinity Amputation and Prosthesis Experience Scale (TAPES), and quality of life with the Short Form-36 (SF-36).

resultsWhen comparing the traumatic and diabetic groups, significant differences favoring the trauma group were found in the following parameters: stride length (SL) (p=0.004), amputated limb step length (ASL) (p=0.019), non-affected limb step length (NSL) (p=0.005), balance assessment parameters of general postural stability (p=0.000), anteroposterior (A-P) postural stability (p=0.000), mediolateral (M-L) postural stability (p=0.007), SCT performance (p=0.000), and the activity restriction subsection of TAPES (p=0.029). No significant differences were observed in gait velocity, cadence, step width, weight-bearing percentage of the amputated and non-affected limbs, TUG performance, SF-36 scores, or the psychosocial adjustment, prosthesis satisfaction, and daily use time subsections of the TAPES.

conclusionIn this study, the use of a VASS prosthesis in both traumatic and diabetic amputees had a positive effect on out-comes in the diabetic group, resulting in comparable results to those of the traumatic group. The fact that diabetic amputees used their prostheses as frequently as traumatic amputees, remained active, and benefited from the choice of prosthesis and suspension system provides valuable insights for healthcare professionals as a facilitating factor in rehabilitation.