Transfemoral amputee’s limit of stability and sway analysis during weight shifting exercise with a vibrotactile feedback system

Abstract

Amputation in the transfemoral amputee (TFA) results in loss of sensory feedback of the amputated limb and therefore results in the poor postural stability. To assess the postural stability, the limit of stability (LOS) is a reliable parameter. In this study, we have investigated the effect of vibrotactile feedback (VF) on the LOS during the weight shifting exercise (WSE) for a TFA. The data of centre of pressure (COP) during WSE was collected from five TFA and five healthy individuals using a zebris force plate. The VF was provided on the amputated/healthy limb’s anterior and posterior part of the stump/thigh during forward and backward WSE, respectively. A customized foot insole with 24 embedded dielectric sensors was used to drive the vibratory motor. The effect of VF was analyzed by pre and post-test. Results show that with the use of VF, TFA significantly improved (t-test, p < .05) the sound limb’s LOS during forward WSE. Also, ANOVA analysis between WSE divisions shows that the prosthetic limb does not follow the path of WSE. We further examine the spectral power using the Welch method to determine the dominant sway frequency of COP. It shows a decreased frequency between 0.5–2 Hz in the healthy and decreased frequency between 0–0.5 Hz and >2 Hz in the amputee with VF. It concluded that VF could improve the LOS of TFA during WSE which ultimately leads to postural stability enhancement.

Keywords:

• Balance
• weight shifting exercise
• limit of stability
• transfemoral amputee

Acknowledgment

We would like to acknowledge Mr. Ajay Babbar for his assistance during the data collection at the gait lab in All India Institute of Medical Sciences (AIIMS), New Delhi. We also acknowledge the amputee participants for their cooperation in this study.

Disclosure statement

The authors report no conflict of interest.

Ethical approval

All procedures performed involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.