Maximising musculoskeletal function for falls prevention in lower-limb amputees

Project Description

The burden of lower-limb amputation and the associated health comorbidities is complex. More than 52% of lower-limb amputees (LLAs) fall each year, with 75% as recurrent fallers. Previous research has made evidence-based recommendations for targeted exercises to improve musculoskeletal function for falls prevention (Vanicek et al.,2009a;2009b;2010;2014) but have yet to be evaluated through structured exercise programmes. The aim is to undertake a targeted falls prevention exercise programme in amputees and evaluate its effectiveness at reducing falls and improving functional performance on daily tasks. This prospective study of an exercise programme in LLAs will use gold standard biomechanical assessments (3D gait, computerised postural analysis, muscle strength) to design individually-tailored exercises based on the participant’s measured musculoskeletal profiles during level and stair walking, sit-to-stand, balance tasks and muscle strength. We will evaluate the effectiveness of the exercises at reducing falls over a 12-month period and maximising functional performance in a group of LLAs. Outcomes will include patient-reported falls, quality-of-life and function (e.g.,LCI-5,ABC-UK) and objective gait-related, postural and strength parameters. Approximately 50 community-dwelling LLAs who have completed a bout of prosthetic rehabilitation will be recruited through prosthetics centre and undergo biomechanical assessments before and after the intervention. Those participants allocated to the exercise group (n=25) will complete a 12-week graded exercise programme that will be partly supervised and home-based. Ongoing revision of the participants’ programme will be monitored. Following evaluation of the outcomes, evidence-based recommendations can be made for structured exercise programmes as part of an amputee’s active prosthetic rehabilitation and/or ongoing care.