Dynamic balance of persons with unilateral upper limb absence when responding to a walking disturbance

IF 1.6 3区心理学 Q4 NEUROSCIENCES

Human Movement Science Pub Date : 2025-02-26 DOI:10.1016/j.humov.2025.103338

Clare Severe , Jenny A. Kent , Paul Hammond II , Matthew J. Major

{"title":"Dynamic balance of persons with unilateral upper limb absence when responding to a walking disturbance","authors":"Clare Severe , Jenny A. Kent , Paul Hammond II , Matthew J. Major","doi":"10.1016/j.humov.2025.103338","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>A high prevalence of falls has been reported in individuals with upper limb absence (ULA). This prevalence is increased in upper limb prosthesis users. It is possible that ULA and prosthesis use may alter recovery mechanisms in response to a perturbation.</div></div><div><h3>Research question</h3><div>The purpose of this study was to investigate the reactive response of individuals with unilateral transradial ULA to perturbations during walking compared to control participants, and to determine the effect of prosthesis use on perturbation response strategies and resultant dynamics.</div></div><div><h3>Methods</h3><div>10 upper limb prosthesis users and 10 matched able-bodied control participants completed two walking treadmill tasks: 1) a steady-state walking baseline trial at 1.0 m/s, and 2) 12 perturbation trials containing an unexpected, rapid treadmill belt acceleration and deceleration while walking. Six perturbations were delivered to each leg during single limb stance. Prosthesis users completed both tasks with and without their customary prosthesis.</div><div>Whole-body angular momentum ranges (<em>L</em><sub><em>range</em></sub>) in each plane during baseline and perturbation response were compared between prosthesis users and controls using one-sided independent <em>t</em>-tests. A two-way repeated measures ANCOVA, with years of prosthesis use modeled as a covariate, assessed the main and interaction effects of prosthesis use and perturbation side of <em>L</em><sub><em>range</em></sub> in three planes, and shoulder add-abduction and flexion-extension ranges in prosthesis users.</div></div><div><h3>Results and significance</h3><div>Prosthesis users exhibited greater <em>L</em><sub><em>range</em></sub> than controls during baseline and perturbation response, in the sagittal-plane only. <em>L</em><sub><em>range</em></sub> during perturbation response was significantly greater when the prosthesis was not worn, also in the sagittal-plane only. Perturbations may present a greater recovery challenge to people with transradial ULA partially due to a mass and inertia imbalance between the sound and impaired limbs when not wearing a prosthesis. Holistic rehabilitation regimes including both prosthesis and balance training should be considered for ULA populations.</div></div>","PeriodicalId":55046,"journal":{"name":"Human Movement Science","volume":"100 ","pages":"Article 103338"},"PeriodicalIF":1.6000,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Human Movement Science","FirstCategoryId":"102","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0167945725000193","RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"NEUROSCIENCES","Score":null,"Total":0}

引用次数: 0

Abstract

Background

A high prevalence of falls has been reported in individuals with upper limb absence (ULA). This prevalence is increased in upper limb prosthesis users. It is possible that ULA and prosthesis use may alter recovery mechanisms in response to a perturbation.

Research question

The purpose of this study was to investigate the reactive response of individuals with unilateral transradial ULA to perturbations during walking compared to control participants, and to determine the effect of prosthesis use on perturbation response strategies and resultant dynamics.

Methods

10 upper limb prosthesis users and 10 matched able-bodied control participants completed two walking treadmill tasks: 1) a steady-state walking baseline trial at 1.0 m/s, and 2) 12 perturbation trials containing an unexpected, rapid treadmill belt acceleration and deceleration while walking. Six perturbations were delivered to each leg during single limb stance. Prosthesis users completed both tasks with and without their customary prosthesis.

Whole-body angular momentum ranges (L_range) in each plane during baseline and perturbation response were compared between prosthesis users and controls using one-sided independent t-tests. A two-way repeated measures ANCOVA, with years of prosthesis use modeled as a covariate, assessed the main and interaction effects of prosthesis use and perturbation side of L_range in three planes, and shoulder add-abduction and flexion-extension ranges in prosthesis users.

Results and significance

Prosthesis users exhibited greater L_range than controls during baseline and perturbation response, in the sagittal-plane only. L_range during perturbation response was significantly greater when the prosthesis was not worn, also in the sagittal-plane only. Perturbations may present a greater recovery challenge to people with transradial ULA partially due to a mass and inertia imbalance between the sound and impaired limbs when not wearing a prosthesis. Holistic rehabilitation regimes including both prosthesis and balance training should be considered for ULA populations.

查看原文本刊更多论文

求助全文

约1分钟内获得全文求助全文

来源期刊

Human Movement Science 医学-神经科学

CiteScore

3.80

自引率

4.80%

发文量

审稿时长

42 days

期刊介绍： Human Movement Science provides a medium for publishing disciplinary and multidisciplinary studies on human movement. It brings together psychological, biomechanical and neurophysiological research on the control, organization and learning of human movement, including the perceptual support of movement. The overarching goal of the journal is to publish articles that help advance theoretical understanding of the control and organization of human movement, as well as changes therein as a function of development, learning and rehabilitation. The nature of the research reported may vary from fundamental theoretical or empirical studies to more applied studies in the fields of, for example, sport, dance and rehabilitation with the proviso that all studies have a distinct theoretical bearing. Also, reviews and meta-studies advancing the understanding of human movement are welcome. These aims and scope imply that purely descriptive studies are not acceptable, while methodological articles are only acceptable if the methodology in question opens up new vistas in understanding the control and organization of human movement. The same holds for articles on exercise physiology, which in general are not supported, unless they speak to the control and organization of human movement. In general, it is required that the theoretical message of articles published in Human Movement Science is, to a certain extent, innovative and not dismissible as just "more of the same."