Physiotherapeutic intervention protocol of easy applicability: clinical effect on gait and prosthesis adaptation of individual with unilateral lower limb amputation

Author(s)

Leticia Vargas de Almeida

• Document type: Doctoral Thesis
• Press: Campinas, SP.
• Institution: Universidade Estadual de Campinas (UNICAMP). Faculdade de Ciências Médicas
• Defense date: 2022-02-04

Examining board members

Alberto Cliquet Junior; José Batista Volpon; Ricardo Machado Leite de Barros; André Luís Lugnani de Andrade; Antonio Carlos Shimano

• Advisor: Alberto Cliquet Junior

Abstract

In this study characterized as a randomized clinical trial, we investigated whether an easily applicable physical therapy intervention protocol was effective in improving gait performance and lower limb prosthesis adaptation in individuals with amputation. A total of 26 individuals participated in the study, 16 with lower limb amputation and 10 without amputation. The participants with amputation were further divided into intervention and control groups. The intervention group was submitted to a rehabilitation protocol that aimed at muscle strengthening of the hip segment, prioritizing the abdominal muscles, hip flexors, extensors, adductors, and abductors, followed by scar mobilization and weight bearing on the stump for desensitization. The evaluation and measurements were made through isometric muscle strength and kinetic and kinematic gait parameters. For the gait parameter variables, in the comparison between pre- and post-intervention, a significant increase in gait speed (0.68 - 2.98, 95% CI, 1.83, ES effect size) and cadence (0.56 - 2.69, 95% CI, 1.63, ES) was found between groups and time points. Step (0.73 - 3.11, 95% CI, 1.92, ES) and stride length (0.62 - 2.84, 95% CI, 1.73) increased between pre- and post-intervention, while in the control group both variables remained smaller. The intervention group decreased the stance phase of the gait cycle between pre and post intervention (-1.33 - 0.62, 95% CI, -36, ES), while there was an increase in the control group. For the muscle strength variables, the effects of the intervention from a clinical perspective demonstrated improved strength performance in the intervention group for maximal extension strength for both limbs. Increased adduction maximal strength for the contralateral limb was also demonstrated. Finally, for abductor maximal strength there was an increase for both limbs. The clinical improvement of the combination of important parameters indicates that the easy to apply physiotherapeutic intervention protocol promoted prosthesis adaptation and functional independence of individuals with lower limb amputation (AU)

• FAPESP's process: 18/02420-0 - Assessment biomechanics of the gait and quality of life of transtibial and transfemoral amputees submitted to the rehabilitation protocol: pre- and post-rehabilitation
• Grantee: Leticia Vargas de Almeida
• Support Opportunities: Scholarships in Brazil - Doctorate