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Rising from the floor in persons with a transtibial amputation: A pilot study
Dennis W Klima1, Brandon Oakley1, Jeremy Banas1
1Department of Physical Therapy, University of Maryland Eastern Shore, Princess Anne, MD, USA.
Background:
Falls are a major concern for persons wearing a prosthesis. Little is known about the ability to rise from the floor among persons with a transtibial amputation (TTA).
Objectives:
The objectives of this pilot study were to (1) identify movement strategies and performance time demonstrated when rising from the floor among persons with a transtibial prosthesis and (2) examine concurrent validity of the timed supine to stand test (TSST).
Study Design:
The study used a cross-sectional design.
Methods:
Eleven participants (9 male; mean age 58.7 [SD 12.7] years) with a unilateral TTA participated. Participants completed a TSST and were observed for common motor strategies, including chair use and half-kneel transitions. Additional outcomes included the Activities-specific Balance Confidence Scale (ABC), Timed Up and Go Test, and Short Physical Performance Battery.
Results:
The mean time to rise from the floor was 10.6 (5.6) s. There was a significant association between TSST performance and age (r = 0.67; P = .03), the ABC (r = -0.72; P = .01), and performance on the Timed Up and Go (r = 0.64; P = .04) and Short Physical Performance Battery (rho = -0.67; P = .007). Six participants (54.5%) required the use of external support (chair) to stand, and 6 (54.5%) initially led with the prosthetic limb to achieve half-kneeling with the prosthetic foot on the surface.
Discussion:
Findings support that the TSST is related to physical performance, age, and ABC among persons with a TTA. A predominant strategy used to rise included the half-kneel position with the prosthetic limb leading. Descriptive findings offer practitioners strategies to teach clients to rise from the floor.

