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  • Exercise Programs Likely to Help People With Lower Limb Amputations, But Best Combination Still Unclear

    There is a need for more definitive and rigorous studies, say researchers, but a new systematic review of the effects of exercise programs on gait performance in people with lower limb amputations points to some positive connections—even if specifics were hard to come by.

    The review, published in the September 28 issue of Prosthetics and Orthotics International (abstract only available for free), found 623 article citations for studies of gait among people with lower limb amputations and eventually whittled acceptable research down to 8 studies involving 199 participants. These studies allowed researchers to compare self-selected gait speed among patients who received specific functional exercise programs, but in the end they did not reveal a single exercise program or combination that could be deemed most effective.

    Authors focused on self-selected gait speed as "the only consistent measure of gait performance" among the studies.

    The actual degree of improvement difference was difficult to pin down, authors write, based in part on inconsistencies in the studies, and wide variation of exercise programs used. Still, they write, "The combined evidence suggests that a variety of different types of exercise can improve self-selected gait speed," and that "improvement in gait performance was seen throughout whether participants were in their third or seventh decade, and whether only men or men and women were combined." No study focused on women only.

    The range of exercises in the studies included activities targeted at supervised walking, specific muscle strengthening, balance, gait training exercise, and functional training focusing on coordination exercises "beyond walking and stair negotiation." Exercise treatment duration ranged from 3 days to 14 months, and from 2 to 40 individual sessions of 30 to 90 minutes. Physical therapists were identified as treatment providers in all but 1 study, which did not specify who provided treatment.

    "Little evidence consistently differentiated which type of exercise was most beneficial," authors write, although improvement occurred "whether most exercise was performed as an unsupervised home exercise program, in focused daily treatments provided within a single week, or in regular sessions spanning months."

    Overall, authors write, the evidence reviewed is only sufficient for a "Grade B" recommendation to support the use of exercise programs that use a range of methods, meaning that more research work needs to be done before a solid analysis can be conducted. "No consensus on a best approach emerged," they write. "This review underscores the need for more and higher quality research into the clinical benefits of specific exercise programs in lower limb amputation rehabilitation."

    Research-related stories featured in PT in Motion News are intended to highlight a topic of interest only and do not constitute an endorsement by APTA. For synthesized research and evidence-based practice information, visit the association's PTNow website.

    Comments

    • I have an above knee amputation on my left leg. I am looking for some kind of help with all the exercises that I can possibly do to get this to work right. It has been for years and so far no help, is there any help you can offer

      Posted by June Casalena on 8/15/2017 2:39 PM

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