Effect of Pre-Prosthetic Training in Balance and Prosthetic Performance in Traumatic Unilateral Trans-Femoral Prosthesis Users in the Age Group of 20-40 Years

Abstract

Background: Amputation at the trans-femoral level can be very challenging for the amputee as well for the surgeon, the prosthetist, the physical therapist. Learning to walk after a trans-femoral amputation is many times harder than learning to walk after a trans-tibial amputation. The trans-femoral amputee not only has to learn to use a prosthetic knee but also must learn to coordinate the interaction of the foot components with the prosthetic knee, which requires more mental energy. The trans-femoral amputee has more difficulty with balance and decreased proprioception and therefore a greater risk and greater fear of falling. For these reasons, the rehabilitation process is much more difficult for the trans-femoral amputee. The physical therapist must also know how to train the patient to function in all mobility situations, and must also be familiar with issues that are relevant to amputees need. Objective: The purpose of the study is to assess of effectiveness of pre-prosthetic training methods in balance and functional outcomes in new trans-femoral prosthetic users. Method: A randomized controlled study with 27 subjects had been recruited on the basis of inclusion criteria and divided into two groups. Group A (N=15, old trans-femoral prosthetic user) using their prosthesis for at least one year regularly for their daily routine as an active community walker and Group B (N=12, first time trans-femoral prosthetic user) and the amputation was a result of trauma with their first trial prosthesis for conventional gait training after the departmental protocol of pre-prosthetic stump conditioning were assessed on the four Performance Oriented Balance and Prosthetic Mobility scales, i.e. TUG, FSST, Cadence and AMP Tool and the pre and post GT and comparison of performance between old and new AK prosthesis users were analysed using paired t test for significance. Results: The pre and post GT has a statistically significant difference in TUG, FSST, cadence and AMP score at p<0.000. When compared between groups; Group A (old) and Group B (new AK) there is a statistically significant difference in the mean performance of TUG and AMP scores at p