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“Trans-Tibial Amputation as a Model to Evaluate the Role of Cutaneous Sensation, Proprioception and Muscular Strength on Balance Performance”


“Trans-Tibial Amputation as a Model to Evaluate the Role of Cutaneous Sensation, Proprioception and Muscular Strength on Balance Performance”

Garcia Escorcia, Jose Luis (2015) “Trans-Tibial Amputation as a Model to Evaluate the Role of Cutaneous Sensation, Proprioception and Muscular Strength on Balance Performance”. Masters thesis, Concordia University.

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Garcia_Escorcia_MSc_S2015.pdf - Accepted Version
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Each year, the United States reports around 185,000 limb amputations (Owings & Kozak, 1998). By the year 2050, amputation’s prevalence is expected to double 2005’ prevalence, affecting close to 3.6 million of individuals (Ziegler-Graham et al., 2008).
The purpose of this research project was to investigate the role of cutaneous sensation, proprioception and muscular strength on balance performance in unilateral traumatic trans-tibial amputees (TTA) under two different conditions, quiet stance and squatting. We proposed that cutaneous sensation, proprioception and strength are reduced in the non-amputated side of TTA. In addition, the center of pressure velocity (COPv), the root-mean-square displacement (RMSd) and the root-mean-square velocity (RMSv) were expected to increase on the non-amputated side. The last hypothesis was that the decrease of balance performance in traumatic TTA is due at least in part to reduced cutaneous information, proprioception and strength.
Seven traumatic TTA (6 M/1F, age: M = 36.0, SD = 12.8 years old) and seven able-bodied controls (6M/1F, age: M = 39.9, SD = 8.1 years old), matched for sex, age, and level of physical activity, volunteered to participate in this project. Balance assessment was conducted through the analysis of center of pressure (COP). The evaluation was performed on the non-amputated limb of traumatic TTA and a randomly selected limb in able-bodied controls during single-legged stance. The test included three random conditions: 1-standing still with eyes open (EO), 2- standing still with eyes closed (EC), and 3- squatting with EO. Three additional measurements on the same limb as balance included: touch pressure sensation (TPS), proprioception, and muscular strength.
The study revealed significant reduction of COPv and RMSv for the medial-lateral (ML) direction in amputees as compared to controls. Muscular strength also evidenced significant differences for the knee and the ankle joints with lower peak-torque-to-body-weight in knee flexors (FLX) and ankle dorsal-flexor (D-FLX) muscles compared to knee extensors (EXT) and ankle plantar-flexor (P-FLX) muscles respectively. Significant correlations were observed between COP variables and muscular strength, in particular to ankle strength.
From our study we can conclude that balance is altered in amputees, with lower values in COPv and RMSv on the sound limb of amputated individuals as compared to able-bodied controls. This decrease in COP variables may represent better balance in amputees that could be explained, at least in part, by amputees relying more on their sound limb on a day-to-day basis during ambulation and standing. However, lower values of COP variables do not necessarily indicate better balance performance as a decrease of COP variables may be related to a reduced ability to control balance.

Divisions:Concordia University > Faculty of Arts and Science > Exercise Science
Item Type:Thesis (Masters)
Authors:Garcia Escorcia, Jose Luis
Institution:Concordia University
Degree Name:M. Sc.
Program:Exercise Science
Date:January 2015
Thesis Supervisor(s):St-Onge, Nancy
Keywords:Amputation Balance Below-knee amputee Center of pressure Cutaneous sensation Muscular Strength Proprioception
ID Code:979654
Deposited On:13 Jul 2015 16:17
Last Modified:18 Jan 2018 17:49
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