[논문]A personalised exercise programme for individuals with lower limb amputation reduces falls and improves gait biomechanics: A block randomised controlled trial

Schafer, Zoe A.; Perry, John L.; Vanicek, Natalie

doi:10.1016/j.gaitpost.2018.04.030

A personalised exercise programme for individuals with lower limb amputation reduces falls and improves gait biomechanics: A block randomised controlled trial 원문보기

Gait & posture, v.63, 2018년, pp.282 - 289

Schafer, Zoe A. (Corresponding author.) , Perry, John L. , Vanicek, Natalie

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Abstract Background Lower limb amputees (LLAs) are at increased risk of falling due to the inherent asymmetry resulting from their limb loss, muscle weakness and other neuro-musculoskeletal limitations. Research question The aim of this study was to evaluate the effects of a personalised exercise programme on falls prevention and gait parameters in LLAs. Methods Fifteen LLAs, recruited from their local prosthetic services centre, were block randomised, by age and level of amputation, into two groups: exercise group (transfemoral, n = 5; transtibial, n = 2) and control group (transfemoral, n = 5; transtibial, n = 3). The exercise group completed a 12-week programme, focusing on strength, balance, flexibility and walking endurance, delivered in group sessions at the University, and combined with a personalised home exercise programme. Temporal-spatial, 3D kinematic and kinetic gait parameters were collected at baseline and post-intervention. Falls incidence was also followed up at 12 months. Results The exercise group experienced significantly fewer falls in the one-year period from baseline, compared with the average annual falls rate, obtained at baseline (P = 0.020; d = 1.54). Gait speed in the exercise group increased by 0.21 m∙s−1, to 0.98 m∙s−1 (P < 0.001; d = 0.91), through increased intact limb cadence. In the pre-swing phase, there were significant increases in intact limb peak vertical force, and affected limb peak propulsive (anterior) force for the exercise group. Power absorption and generation significantly increased at both the intact and affected hip joints (H3) and the intact ankle (A1 and A2) for the exercise group, resulting in significant group*time interactions. Significance This is the first study to document the clinically meaningful benefits of an exercise intervention for falls prevention and gait performance in LLAs. Specialised exercise programmes for community-dwelling LLAs should be implemented as a method to reduce falls and improve walking performance in this population. Highlights A 12-week personalised exercise programme reduced falls in lower limb amputees. Walking speed increased by 0.21 m∙s−1, indicating a clinically meaningful change. Bilateral improvements in concentric power generation were seen at the hip. The intact ankle demonstrated increases in concentric and eccentric power. Participants evidenced more confidence transitioning into prosthetic single support.

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A personalised exercise programme for individuals with lower limb amputation reduces falls and improves gait biomechanics: A block randomised controlled trial 원문보기

Abstract ▼ AI-Helper

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