Name: Shloak Manan Mehta
E-mail: smm315@ic.ac.uk
Occupation: PhD Student
Imperial College London, UK
Other authors: Dario Farina, Alison McGregor, Silvia Muceli, Agnes Sturma,Saeed Zahedi
ABSTRACT
Objective: To investigate the
proprioceptive sensibilities of cutaneous socket sensation for lower limb
amputees.
Design: Anonymous survey.
Setting: Online (international)
recruitment was done through special interest amputee groups and social
media pages, posters and word of mouth.
Participants: 115 unilateral lower
limb amputees who use leg prostheses Amputation Level: below-knee 64;
above-knee 46; through-knee 3; through-ankle 1; through-hip 1. Age (years):
18-60: 85; over-60: 26; unknown: 4 Gender: female 33; male 78; unknown 4.
Interventions: N/A
Main Outcome Measure(s): Likert-type (1-5) strongly
disagree/agree self-reported measures of prosthetic sensibility including:
perception of foot-ground clearance, prosthetic ankle proprioception and
foot-ground information (e.g. “When climbing stairs, I can feel how much of
my foot is on the step”, “I can feel when I've stepped on an object”),
slope/unevenness, surface type and hardness. ‘Activities-Specific Balance
Confidence (ABC) Scale was also included.
Results: Ankle proprioception
(2.8/5) and foot-ground clearance (3.2/5) were the poorest perceived while
detecting ground unevenness/slope was the best (4.2/5). Non-parametric
Kruskal-Wallis showed significant differences in reported sensibility
between foot clearance and ground unevenness/slope (p= 1.5e-06, d=0.69),
ankle proprioception and ground unevenness/slope (p=1.4e-12, d=0.91). There
were no significant differences between perceived sensibility of uneven
slope, floor hardness, floor type and detecting objects under feet. Ankle
proprioception and foot-ground clearance were also significantly correlated
(p<0.0001) to Balance Confidence and Embodiment (R~0.6). Furthermore,
foot clearance was significantly correlated (p<0.0001) to fear of
falling (R=-0.4).
Conclusions: This survey suggests that unilateral
amputees find ankle proprioception and foot clearance the most difficult to
perceive, yet these strongly affected fear of falling, balance confidence,
and embodiment. Hence, sensory feedback devices that restore ankle
proprioception and augment foot-ground clearance feedback could significantly
improve performance outcomes and clinicians should include exercises to
train prosthetic proprioception.
Key Words: Feedback, Sensory,
Proprioception, Amputees, Rehabilitation
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