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

IF 1.9 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

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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.

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单侧上肢缺失者对行走障碍的动态平衡反应

背景：据报道，上肢缺失（ULA）患者的跌倒发生率很高。在上肢假体使用者中患病率增加。这是可能的ULA和假体的使用可能会改变恢复机制，以响应扰动。研究问题：本研究的目的是研究单侧经桡骨ULA患者在行走过程中对摄动的反应性反应，并确定假体使用对摄动反应策略和结果动力学的影响。方法10名上肢假肢使用者和10名匹配的健全对照者完成了两项跑步机行走任务：1)1.0 m/s的稳态行走基线试验，2)12项摄动试验，其中包括行走时意外的快速跑步机带加速和减速。在单肢站立时，对每条腿进行6次扰动。假体使用者使用和不使用他们习惯的假体完成了两项任务。采用单侧独立t检验比较假体使用者和对照组在基线和扰动反应期间每个平面的全身角动量范围（Lrange）。采用双向重复测量ANCOVA，将假体使用年限建模为协变量，评估假体使用和Lrange摄动侧在三个平面上的主效应和交互效应，以及假体使用者肩部外展和屈伸范围。结果和意义假体使用者在基线和摄动反应中表现出比对照组更大的Lrange，仅在矢状面。当假体未被磨损时，摄动响应期间的Lrange明显更大，也仅在矢状面。摄动可能会给桡骨侧ULA患者带来更大的恢复挑战，部分原因是当不佩戴假体时，声音和受损肢体之间的质量和惯性不平衡。对于ULA人群，应考虑包括假体和平衡训练在内的整体康复制度。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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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."