Thranhardt Lecture Series focuses on vestibular sensory, gait

CHICAGO — A speaker here at American Academy of Orthotists and Prosthetists Annual Meeting and Scientific Symposium discussed the relationship between vestibular sensory integration and mobility in patients with lower limb amputation. The presentation was a part of the Thranhardt Lecture Series.

“People with lower limb loss have a significant loss of somatosensory information due to loss of proprioceptors within the limb,” Jennifer L. Lučarević, PT, DPT, a PhD candidate at the Miller School of Medicine, said. “Therefore, using the information from a visual and vestibular system is critical during static and dynamic activities. This is the first study to examine the contributions of vestibular sensory integration into mobility in those with lower limb loss.”

Researchers developed a vestibular system, which Lučarević described as an “internal GPS for head position and movement.” The system includes static, angular and linear positions.

The researchers then conducted a study of the system on 130 adults, aged 20 years through 80 years. Each participant had less than 3 months of use with their current prosthesis and could stand and ambulate independently with a cane. Participants completed the Prosthetic Limb Users’ Survey of Mobility, the Component Timed Up and Go Test and a self-reported take-home survey.

According to the results, self-perceived and performance-based mobility improved with the use of the system. Lučarević said further research is needed to refine the data.

Jonathan S. Akins, PhD, of Widener University, who also spoke in the Thranhardt Lecture Series, presented research that suggested lower limb prosthesis users with a history of falls have worse turning gait performance, reduced sit-to-stand transfer ability and reduced balance confidence when compared to non-fallers.

Researchers conducted a study of 69 prosthesis users with unilateral lower limb amputation. They used the Activities-specific Balance Confidence Scale, the Figure-of-8 Walk Test (F8WT) and the 30 Second Sit-to-Stand (STS) test. They also conducted research to determine if participants classified as fallers had lower balance confidence, slower F8WT times and reduced STS transfer ability compared to non-fallers.

“The [research] explores outcome measures that may have clinical value in helping determine fall risk,” Akins said. “Currently, only 30% of prosthetists are using outcome measures. These measures are easy to administer and require minimal space and equipment.”

According to the findings, fall rate in the study was 53.6%. Akins said the study had a limited population and that the assessments did not consider spatiotemporal or kinematic measures. However, he said the tests appear to be reliable and could be used as a method of assessing turning ability and lower extremity functional strength. – by Shawn M. Carter


Akins JS and Lučarević JL. Thranhardt Lecture Series presentations. Presented at: American Academy of Orthotists and Prosthetists Annual Meeting and Scientific Symposium; March 1-4, 2017; Chicago.

Disclosure: Akins reports grant and research funding from the Foundation for Physical Medicine and Rehabilitation and Widener University. Lučarević reported no relevant financial disclosures.

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