Whole-body Vibration Without Visual Feedback on Postural Steadiness in Unilateral Trans-femoral Traumatic Amputees

MTI University115 enrolled

Overview

This study will investigate the effects of Whole-body vibration without visual feedback on postural steadiness in unilateral trans-femoral traumatic amputees. This study will be carried out at the outpatient clinic of the faculty of physical therapy, modern university for technology and information, and El Wafaa wel Amal hospital. All participants will sign a written consent form after receiving full information about the purpose of the study, procedure, possible benefits, privacy, and use of data.

The postural steadiness is the dynamics of the postural control system associated with maintaining balance during quiet standing and usually assessed by the displacement of the centre of pressure (COP). The control of posture is maintained by a complex sensory-motor system, which integrates information from the visual, proprioceptive, vestibular and somato-sensory systems. In the case of a unilateral trans femoral amputee, the individual becomes structurally asymmetrical, as there is an altered sensation and a loss of musculature on the amputated side. Whole-body vibration (WBV) is a therapeutic method that exposes the entire body to mechanical oscillations while the patient stands or sits on a vibrating platform. This method was used in rehabilitation to improve muscle function, joint stability, balance control and to reduce the risk of falling. Whole-body vibration (WBV) training helps to improve the dysfunction of the nervous system and musculoskeletal system diseases, to prevent and relieve osteoporosis in the elderly, and to promote sports injury recovery and improve sports performance. But till now there is no judgment concerning the difference and significance of Whole-body vibration without visual feedback on postural steadiness in unilateral trans-femoral traumatic amputees.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

115

Conditions

Amputation; Traumatic, Leg, Lower

Interventions

Whole-body vibration plus conservative careDEVICE

Whole-body vibration (WBV) is a therapeutic method that exposes the entire body to mechanical oscillations while the patient stands or sits on a vibrating platform. This method was used in rehabilitation to improve muscle function, joint stability, balance control and to reduce the risk of falling.

conservative careOTHER

1. Stretching and ROM exercises daily to make sure that the patient can straighten hip; this makes walking, and even lying in bed, more comfortable. 2. Resting hip on a pillow, as this promotes a hip flexion contracture 3. A pillow between legs, as this lengthens the inner thigh muscle that helps to keep legs together while walking, and shortens the outer thigh muscles so that walking and standing with feet apart. 4. Regular skin care. 5. Regular prosthetic care.

Eligibility

Sex: ALLMin age: 40 YearsMax age: 55 Years

Medical Language ↔ Plain English

Inclusion Criteria: * 40 to 55 years of age. * Residual femoral length from ischial tuberosity to the end of the limb with distal soft tissue compressed (15-35 cm) * Unilateral trans-femoral traumatic amputation with single-axis mechanical knees, axial foot (single axis). * Able to walk without the use of any assistive device; subjects must have obtained a score of \> 5 for Houghton Scale to indicate active use of prosthesis and \> 41 for Berg Balance Scale (BBS). * Medicare level 3 (community) ambulatory or above. * Ability to descend stairs and hills without caregiver and assistive devices. * Be able to independently provide informed consent. * Be willing to comply with study procedures. Exclusion Criteria: * Reduced somatosensory sensibility of the non-affected limb, ulceration or pain at the stump * the amputation was of vascular origin * Poor fittings of prosthesis * Visual or vestibular impairment (vertigo or dizziness) * Lower limb musculoskeletal injury and other neurological deficits

Locations (1)

Ahmed Mohamed Ahmed Abdelhady

Cairo, Egypt

Outcomes

Primary Outcomes

Prosthetic leg stability test

Prior to testing, the subject will be asked to center the foot on the platform in a position that will be level and stable. This foot placement will maintained through -out all 3 trials for the prosthetic leg. This position will be used as the level reference point from which degree of displacement was measured. The subject will instructed to stand on foot with the knee slightly flexed (15°) on the platform, with the contralateral knee flexed to 90° for 20 seconds (test period). Level 8 will be selected for use during testing

Time frame: base line and after 12 weeks.

Secondary Outcomes

Sway Index

The CTSIB (Modified Clinical Test of Sensory Interaction on Balance) is a standard test for postural steadiness on different surfaces. This test was designed to assess the patient's ability to integrate sensory information to maintain body equilibrium.

Time frame: base line after 12 weeks

Limits of Stability Test

The subjects will be asked to move directly toward the target, the best expected outcome was a straight path. During this test, 8 targets will be presented in each direction, and the subjects were randomly given instructions. The subjects will be requested to move their centre of gravity toward the targets, touch them, and then return to the center.

Time frame: base line after 12 weeks

Data from ClinicalTrials.gov

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