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Do predictive relationships exist between postural control and falls efficacy in unilateral transtibial prosthesis users?

Barnett, Cleveland T.; Vanicek, Natalie; Rusaw, David F.


Cleveland T. Barnett

David F. Rusaw


Objective: To assess whether variables from a postural control test relate to and predict falls efficacy in prosthesis users.

Design: Twelve-month within and between subjects repeated measures design. Participants performed the Limits of Stability (LOS) test protocol at study baseline and at 6-month follow-up. Participants also completed the Falls Efficacy Scale-International (FES-I) questionnaire, reflecting the fear of falling, and reported the number of falls monthly between study baseline and 6-month follow-up, and additionally at 9- and 12-month follow-ups.

Setting: University biomechanics laboratories.

Participants: A group of active unilateral transtibial prosthesis users of primarily traumatic etiology (PROS) (n=12) with at least one year of prosthetic experience and age and gender matched control participants (CON) (n=12).

Interventions: Not applicable.

Main Outcome Measure(s): Postural control variables derived from centre of pressure data obtained during the LOS test, which was performed on and reported by the Neurocom Pro Balance Master, namely; reaction time (RT), movement velocity (MVL), endpoint (EPE) and maximum (MXE) excursion and directional control (DCL). Number of falls and total FES-I scores.

Results: During the study period, the PROS group had higher FES-I scores (U = 33.5, p=0.02), but experienced a similar number of falls, compared to the CON group. Increased FES-I score were associated with decreased EPE (R=-0.73, p=0.02), MXE (R=-0.83, p less than .01) and MVL (r= −0.7, P=.03) in the prosthesis users group, and DCL (r= −0.82, P less than .01) in the control group, all in the backward direction.

Study baseline measures of postural control, in the backward direction only, are related to and potentially predictive of subsequent 6-month FES-I scores in relatively mobile and experienced prosthesis users.


Barnett, C. T., Vanicek, N., & Rusaw, D. F. (2018). Do predictive relationships exist between postural control and falls efficacy in unilateral transtibial prosthesis users?. Archives of physical medicine and rehabilitation, 99(11), 2271-2278.

Journal Article Type Article
Acceptance Date May 11, 2018
Online Publication Date Jun 18, 2018
Publication Date Nov 1, 2018
Deposit Date Jun 26, 2018
Publicly Available Date Jun 19, 2019
Journal Archives of Physical Medicine and Rehabilitation
Print ISSN 0003-9993
Electronic ISSN 1532-821X
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 99
Issue 11
Pages 2271-2278
Keywords Physical Therapy, Sports Therapy and Rehabilitation; Rehabilitation
Public URL
Publisher URL


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