Dynamic balance training during standing in people with trans-tibial amputation: a pilot study

Falls and fear of falling are significant problems arising from impaired balancing abilities that affect people with lower limb amputation during unassisted transfer manoeuvres and ambulation. It is important to develop and evaluate efficient therapeutic interventions aimed at improving balancing and coordination skills. A group of 14 persons after trans-tibial amputation, fitted with trans-tibial prostheses, were included in a balance-training programme, consisting of approximately 20 minutes of balance training per day for five consecutive days on BalanceReTrainer--a novel balance-training, fall-safe mechanical apparatus. Before and after the training period three outcome measures were taken: duration of standing only on the prosthetic leg, timed up and go test and 10m walk. Each measurement was repeated five times and the mean value was used in the subsequent calculation of mean values and standard deviations for the group. Before training the group was able to stand on the prosthetic leg for 2.98 +/- 2.75s, they needed 6.15 +/- 1.9s for accomplishing timed up and go test and they needed 5.51 +/- 1.5s to cover the distance of 10m. After the treatment period the values were 4.3 + 4.5s, 5.4 +/- 1.5s and 4.5 +/- 0.9s, respectively. The results indicate improved performance in all three measured tasks, thereby indicating that the applied treatment programme improves balancing and ambulation abilities in people after trans-tibial amputation.