Abstract
Introduction: Lower-limb prosthesis users (LLPUs) experience increased fall risk due to gait and balance impairments. Clinical outcome measures are useful for measuring balance impairment and fall risk screening but experience limited resolution and ceiling effects. Recent advances in wearable sensors that can measure different components of gait stability may address these limitations. This study assessed feasibility and construct validity of a wearable sensor system (APDM Mobility Lab) to measure postural control and gait stability. Materials and Methods: Lower-limb prosthesis users (n = 22) and able-bodied controls (n = 24) completed an Instrumented Stand-and-Walk Test (ISAW) while wearing the wearable sensors. Known-groups analysis (prosthesis versus controls) and convergence analysis (Prosthetic Limb Users Survey of Mobility [PLUS-M] and Activities-Specific Balance Confidence [ABC] scale) were performed on 20 stability-related measures. Results: The system was applied without complications; however, missing anticipatory postural adjustment data points for nine subjects affected the analysis. Of the 20 analyzed measures output by the sensors, only three significantly differed (P < 0.05) between two cohorts, and two demonstrated statistically significant correlations with the self-report measures. Conclusions: The results of this study suggest the clinical feasibility but only partial construct validity of the wearable sensor system in conjunction with the ISAW test to measure LLPU stability and balance. The sample consisted of high-functioning LLPUs, so further research should evaluate a more representative sample with additional outcome measures and tasks.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 213-222 |
| Number of pages | 10 |
| Journal | Journal of Prosthetics and Orthotics |
| Volume | 33 |
| Issue number | 3 |
| DOIs | |
| State | Published - 2021 |
Funding
This work was supported in part by the US Department of Veterans Affairs Rehabilitation Research and Development Service (#1IK2RX001322-01A1) and the American Academy of Orthotists and Prosthetists (AAOP). Contents do not represent the views of the US Department of Veterans Affairs or the US Government. KYLE T. MILLER, MPO, CO; MOLLY RUSSELL, MPO, LCPO; TERESE JENKS, MPO, LCO; KADDIE SURRATT, MPO, CPO; and MATTHEW J. MAJOR, PhD are affiliated with the Northwestern University Prosthetics-Orthotics Center, Chicago, Illinois. KELLY PORETTI, MSE; SAMANTHA S. EIGENBROT, MSE; and JONATHAN S. AKINS, PhD are affiliated with the Department of Biomedical Engineering, Widener University, Chester, Pennsylvania. MATTHEW J. MAJOR, PhD is affiliated with the Jesse Brown VA Medical Center, Chicago, Illinois. All authors contributed equally in the preparation of this article. Disclosure: The authors declare no conflict of interest. Funding: This work was supported in part by the US Department of Veterans Affairs Rehabilitation Research and Development Service (#1IK2RX001322-01A1) and the American Academy of Orthotists and Prosthetists (AAOP). Contents do not represent the views of the US Department of Veterans Affairs or the US Government. Copyright © 2020 American Academy of Orthotists and Prosthetists.
Keywords
- Balance
- Gait
- Lower-limb prosthesis
- Outcome measures
- Wearable sensors
ASJC Scopus subject areas
- Biomedical Engineering
- Orthopedics and Sports Medicine
- Rehabilitation