Determination of the effects of playing soccer on physical fitness in individuals with transtibial amputation

Quantitative methods used to evaluate balance, postural control, and the fear of falling in lower limb prosthesis users: A systematic review

Problems with balance, postural control, and fear of falling are highly prevalent in lower limb prosthesis users, with much research conducted to understand these issues. The variety of tools used to assess these concepts presents a challenge when interpreting research outcomes. This systematic review aimed to provide a synthesis of quantifiable methods used in the evaluation of balance, postural control, and fear of falling in lower limb prosthesis users with an amputation level at or proximal to the ankle joint. A systematic search was conducted in CINAHL, Medline, AMED, Cochrane, AgeLine, Scopus, Web of Science, Proquest, PsycINFO, PsycArticles, and PubPsych databases followed by additional manual searching via reference lists in the reviewed articles databases. Included articles used quantitative measure of balance or postural control as one of the dependent variables, lower limb prosthesis users as a sample group, and were published in a peer-reviewed journal in English. Relevant assessment questions were created by the investigators to rate the assessment methods used in the individual studies. Descriptive and summary statistics are used to synthesize the results. The search yielded (n = 187) articles assessing balance or postural control (n = 5487 persons in total) and (n = 66) articles assessing fear of falling or balance confidence (n = 7325 persons in total). The most used test to measure balance was the Berg Balance Scale and the most used test to measure fear of falling was the Activities-specific Balance Confidence scale. A large number of studies did not present if the chosen methods were valid and reliable for the lower limb prosthesis users. Among study limitations, small sample size was common.

Effectiveness of (Active) Lifestyle Interventions in People With a Lower Limb Amputation: A Systematic Review

Objective

To explore the effectiveness of (active) lifestyle interventions for the health of people with a lower limb amputation in order to offer effective interventions during rehabilitation that may improve physical and psychosocial functioning of people with lower limb amputation.

Data Sources

PubMed, CINAHL and Embase were searched from inception to February 2021.

Study Selection

Inclusion criteria were (1) (quasi-)randomized controlled trial; (2) minimum of 10 participants with a lower limb amputation; (3) lifestyle intervention focusing on physical activity, smoking habits, alcohol use, nutrition, and/or stress management; (4) focus on health outcomes; (5) participants older than 18 years; (6) studies in Dutch, German, or English; and (7) primary research. Title, abstract, and full-text screening and quality assessment were performed by 2 independent assessors.

Data Extraction

Of 2460 studies identified, 13 studies were included in this review. Two studies were of moderate methodological quality, 2 studies were of medium quality, and 9 studies were of poor quality.

Data Synthesis

Lifestyle interventions in the included studies focused on physical activity and stress management. These interventions seemed effective for improving physical fitness, walking capacity, changes in body mass, quality of life, and intensity of physical activity.

Conclusion

Lifestyle interventions focusing on physical activity and stress management seem effective for improving physical and psychosocial functioning of people with a lower limb amputation. However, the findings should be interpreted with caution given the limited methodological quality of the included studies. Future research should evaluate the effectiveness of interventions on nutrition, smoking habits, and alcohol use and the effectiveness of combined interventions in people with a lower limb amputation.

A comparison of physical performance analyses of amputee professional and elite footballers

BACKGROUND

The aim of this study was to evaluate the physical fitness and performance parameters of elite and professional footballers, and for these results to form a guide for training programs for amputee footballers at the amateur or professional level to be able to reach elite level.

METHODS

A total of 24 footballers with extremity amputation were separated into 2 groups as elite (N.=12) and professional (N.=12). Using field tests, the footballers were evaluated in respect of body composition, anaerobic and aerobic strength, speed, muscular endurance and balance.

RESULTS

No statistically significant difference was determined between the footballers included in the study in respect of the number of days engaged in sport and the number of training sesions per week (P>0.05). Of the parameters used to evaluate aerobic and anaerobic strength, the vertical jump distance and relative strength measurement values were determined to be statistically significantly higher in the elite players than in the professional players (P<0.001 for all). In the evaluation of the muscle strength, endurance and balance parameters, the push-up test, trunk flex muscle strength and quadriceps endurance values were determined to be statistically significantly higher in the elite footballers (P<0.001, P<0.001, P=0.008, respectively).

CONCLUSIONS

One of the ultimate aims of footballers to be an elite football player requires the highest level of physical performance and technical capabilities. The results of this study have clearly shown the differences between elite and professional players with amputations. These findings can be of guidance for professional footballers and trainers to be able to reach maximal performance.

Postural Control during Progressively Increased Balance-Task Difficulty in Athletes with Unilateral Transfemoral Amputation: Effect of Ocular Mobility and Visuomotor Processing

This study examined postural control during single leg stance test with progressively increased balance-task difficulty in soccer players with unilateral transfemoral amputation (n = 11) compared to able-bodied soccer players (n = 11). The overall stability index (OSI), the anterior/posterior stability index, and the medial/lateral stability index during three balance tasks with increasing surface instability were estimated. The oculomotor and visuomotor contribution to postural control in disabled athletes was analyzed. Oculomotor function, simple and choice reaction times, and peripheral perception were assessed in a series of visuomotor tests. The variation in OSI demonstrated significantly greater increases during postural tests with increased balance-task difficulty in the able-bodied soccer players compared to amputees (F_(2,40) = 3.336, p < 0.05). Ocular mobility index correlated (p < 0.05) with OSI in conditions of increasing balance-task difficulty. Moreover, speed of eye-foot reaction has positive influence (p < 0.05) on stability indexes in tasks with an unstable surface. Amputee soccer players displayed comparable postural stability to able-bodied soccer players. Disabled athletes had better adaptability in restoring a state of balance in conditions of increased balance-task difficulty than the controls. The speed of visuomotor processing, characterized mainly by speed of eye-foot reaction, significantly contributed to these results.

Selecting, Administering, and Interpreting Outcome Measures among Adults with Lower-Limb Loss: An Update for Clinicians

Purpose of review

To summarize outcome measurement research among adults with lower-limb loss (LLL) for clinicians.

Recent findings

Houghton Scale, Prosthetic Evaluation Questionnaire-mobility subscale (PEQ-m), Prosthetic Limb Users Survey of Mobility (PLUS-M™), Activities-Specific Balance Confidence Scale (ABC), Amputee Mobility Predictor (AMP), Comprehensive High-Level Activity Mobility Predictor, Four Square Step Test (FSST), Narrowing Beam Walking Test (NBWT), L Test, 10 Meter Walk Test (10MWT), and 6 Minute Walk Test (6MWT) are appropriate for evaluating individual patient changes post-LLL. Post-LLL, Socket Comfort Score, Patient-Specific Functional Scale, Patient-Reported Outcomes Measurement Information System 29-Item Profile, Timed Up and Go, and 2 Minute Walk Test may be more appropriate for evaluating groups. Minimal detectable change is available for 15/20 reviewed measures. Many measures differ between mobility levels.

Summary

Quick, reliable measures for evaluating patient functional change include ABC, PEQ-m, PLUS-M™, FSST, and L Test; when resources allow, NBWT, 10MWT, 6WMT and AMP may be considered.