Do Predictive Relationships Exist Between Postural Control and Falls Efficacy in Unilateral Transtibial Prosthesis...

Area of Science:

• Biomechanics
• Prosthetics and Orthotics
• Rehabilitation Science

Background:

• Fear of falling (FES-I scores) is a significant concern for prosthesis users, impacting their mobility and quality of life.
• Postural control is crucial for maintaining balance and preventing falls, especially in individuals with lower-limb loss.

Purpose of the Study:

• To investigate the relationship between postural control variables and fear of falling in unilateral transtibial prosthesis users.
• To determine if postural control measures can predict future falls efficacy in this population.

Main Methods:

• A 12-month repeated measures design was employed with 24 participants (12 prosthesis users, 12 controls).
• The Limits of Stability (LOS) test was used to assess postural control, measuring reaction time, movement velocity (MVL), endpoint excursion (EPE), maximum excursion (MXE), and directional control (DCL).
• Falls Efficacy Scale-International (FES-I) scores and self-reported falls were collected throughout the study period.

Main Results:

• Prosthesis users reported higher FES-I scores compared to controls, indicating greater fear of falling.
• Decreased EPE, MXE, and MVL in the backward direction were significantly associated with increased FES-I scores in prosthesis users.
• Directional control (DCL) in the backward direction was also associated with FES-I scores in the control group.

Conclusions:

• Baseline postural control measures, particularly in the backward direction, are related to fear of falling in prosthesis users.
• These postural control variables show potential for predicting future falls efficacy in relatively mobile and experienced prosthesis users.
• Improving backward postural control may be a target for interventions aimed at reducing fear of falling in individuals using prostheses.