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Purpose: This study was planned to investigate falls, their frequency, reasons, and consequences in the older patient with lower limb amputations. Methods: Twenty-five patients with lower limb amputations were included in the study. A questionnaire for falling was applied. Functional levels of these patients were determined according to the Medicare Functional Level System. Results: The falling questionnaire revealed that except for 5 patients with amputations, the subjects had experienced an incident of falling once or more than once. The common reasons for falls turned out to be losing balance, stumbling on the prosthesis, and colliding with someone. Conclusions: It was concluded that performing comprehensive evaluations in which falling histories were assessed before planning rehabilitation programs enriched the rehabilitation programs by suggesting different types of activities. [ABSTRACT FROM AUTHOR]

This retrospective study was designed for the period 1982-2002 to collect the basic data on the demography, level and side of the amputation, involved limbs, age, gender, and prosthetic functional level in children with limb loss. A total of 232 children were assessed through their prosthetic records. Seventy-two percent (195 children) presented lower-limb involvement, and 28% (77 children) had upper-limb loss. The age of the children varied between 1 and 15 years with a mean age of 9.90 +/- 2.32 years. Results of the study revealed that the leading amputation cause in children was congenital limb absence. The most frequent levels were determined as trans-tibial and trans-radial in lower and upper limbs, respectively. Findings showed that more boys (60%) were affected, and 84% of all amputations were found to be unilateral. It was also seen that right-side amputations (54%) were more common than left-side amputations (46%). The outcome of the study showed that 96% of children with lower-limb loss reached a functional gait pattern without any aids, while the percentage of independence in activities of daily living was found to be 88% in upper-limb loss. [ABSTRACT FROM AUTHOR]

Background: Amputation is a major life-changing event and is regarded as one of the loading causes of permanent disability. However, amputation often causes changes in painful and nonpainful sensory experiences. Pain after amputation has been shown to increase functional limitations caused by limb loss and lower quality of life., Objective: This study aimed to examine the effect of pain on activity and participation in individuals with unilateral below-knee amputations according to the International Classification of Functioning, Disability, and Health., Study Design: Cross-sectional study., Methods: In the study, 64 individuals were divided into 2 groups: those who experienced pain and those who did not. Group 1 included 33 below-knee amputees who experienced pain (27 males, mean age 43.9 ± 12.6 years) and Group 2 included 31 below-knee amputees who did not experience pain (25 males, mean age 47.4 ± 12.1 years). The McGill Pain Questionnaire and visual analog scale were used to assess pain, the Prosthetic Limb Users Survey of Mobility was used to assess activity, and the Reintegration to Normal Living Index was used to assess participation., Results: Demographic characteristics of the 2 groups were statistically insignificant ( P > 0.05). The nonpainful group had significantly higher activity and participation scores than the painful group ( P < 0.001)., Conclusions: It was found that phantom pain and stump pain in below-knee amputees limited activity and participation. It was also shown that phantom pain has a more negative effect on the activity level of individuals than stump pain., (Copyright © 2024 International Society for Prosthetics and Orthotics.)

Background: In this study, we aimed to evaluate the viscoelastic properties of the superficial back muscles of adolescent idiopathic scoliosis patients with Lenke Type 1A and 1B curves compared to their healthy peers., Methods: 20 participants with adolescent idiopathic scoliosis and 20 healthy peers were evaluated. Cobb angle was recorded for scoliosis participants. The upper, middle, and lower trapezius muscles, and latissimus dorsi muscles were evaluated bilaterally with Myoton-3 as stiffness, elasticity and tone parameters for all participants., Findings: Cobb angle was 20.30 ± 8.52° for participants with adolescent idiopathic scoliosis. Muscular stiffness in participants with scoliosis was greater than that of the healthy group for all muscles and both sides. Muscle elasticity was only different for the latissimus dorsi and middle trapezius muscles for the left side and they showed significantly decrease in participants with scoliosis. There was no statistical difference in muscle tone between the groups (p > 0.05)., Interpretation: Our findings suggest that adolescents with idiopathic scoliosis exhibit increased muscular stiffness bilaterally in superficial back muscles, decreased muscle elasticity on the concave side of the curve compared to healthy peers suggests potential implications for the biomechanics and rehabilitation of adolescent idiopathic scoliosis., Competing Interests: Declaration of competing interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

The International Classification of Functioning, Disability, and Health (ICF) provides a universal framework for assessing the functioning of any person. To facilitate the application of the ICF in practice, ICF core sets are being developed. This study is part of a project intended to develop an ICF core set for upper-limb amputation (ULA) and aims to identify relevant concepts included in the outcome measurements used in studies of ULA. Articles involving ULA aged 18 years or older from January 2011 to December 2021 were searched on Cumulative Index to Nursing and Allied Health Literature, SPORTdiscus, and Medical Literature Analysis and Retrieval System Online. We included studies with particular designs (randomized controlled trials, before/after studies, cross-sectional studies, and longitudinal observational studies) and published in English. Relevant concepts were extracted from measurements and linked to the ICF using linking rules, and a frequency analysis was conducted. Sixty-one of the 1272 identified publications were included, from which 86 measurements were extracted. Concepts extracted from measurements were linked to 129 ICF categories. Three hundred twenty-six (29.23%) of the 1115 concepts were related to body functions, 643 (57.66%) to activity and participation, 96 (8.60%) to environmental factors, 19 (1.70%) to body structures, and 6 (0.53%) to personal factors. Twenty-five (2.24%) were characterized as "nd-not definable." "Fifty-four" categories identified in at least 5% of the publications will be considered for inclusion in the final ICF core set for ULA during the consensus conference. This review provides information about the content of measures, and the identified ICF categories reveal the research perspective for developing an ICF core set for ULA., (Copyright © 2024 International Society for Prosthetics and Orthotics.)

Buerger disease is a nonatherosclerotic, segmental inflammatory disease of the occlusive tract, often involving medium-sized muscular and small-diameter arteries and veins of the extremities. If medical treatment is not successful, amputation is inevitable. The aim of this study was to investigate the effect of different kinesiological taping techniques on walking parameters of transtibial amputee with knee extension limitation. Two different kinesiological taping methods (Kinesio Tape and Dynamic Tape) were applied to the transtibial patient with knee extension limitation. Walking performance of patients was assessed with The Biodex Gait Trainer 2. Gait parameters without tape were as follows: average walking speed 0.38 m/s, average step cycle 0.48 cyl/s, average left step length 50 cm, average right step length 43 cm, coefficient of variation 9% at the left, and coefficient of variation 9% at the right. After applying Kinesio Tape and Dynamic Tape, these values were measured as follows: average walking speed 0.50.56 m/s, average step cycle 0.51.56 cyl/s, average left step length 61-60 cm, average right step length 53-54 cm, coefficient of variation 6%-5% at the left, and coefficient of variation 6%-4% at the right side. Dynamic Tape and Kinesio Tape both had positive effects on active joint motion and walking parameters. Regarding walking speed and step length, Dynamic Tape was found to be more effective than Kinesio Tape. Taping methods applied to amputees have positive effects on range of motion, which in return causes improvements on walking parameters., (Copyright © 2024 International Society for Prosthetics and Orthotics.)

Background: Optimization of mobility activities with spinal stabilization exercises and reducing spinal loads in individuals with transtibial amputation are recommended by researchers; however, the effect of spinal stabilization exercises on functional exercise capacity has not been investigated., Objective: This study aims to investigate the effect of spinal stabilisation exercises on functional exercise capacity in individuals with transtibial amputation., Study Design: Randomized controlled trial with concealed allocation, assessor blinding., Methods: Eighteen individuals with transtibial amputation were included. Conventional physiotherapy program was applied to individuals in control group, and spinal stabilization exercise training was applied to individuals in intervention group together with conventional physiotherapy program for 8 weeks. The primary outcome was maximal oxygen uptake during 6-Minute Stepper Test. The secondary outcomes were maximal energy expenditure, step count and fatigue during 6-Minute Stepper Test, perceived mobility level with prosthesis, and stabilization strength of deep spinal muscles., Results: In the within-group comparisons, the change in the functional exercise capacity, step count, and stabilization strength of deep spinal muscles were found to be statistically significant in both groups. In the between-group comparison, the changes in the functional exercise capacity, perceived mobility level, and stabilization strength of deep spinal muscles were found to be significant in favor of the group in which spinal stabilization exercises were applied., Conclusions: Along with improvement in proximal control of movement, improvements were observed in some parameters that are indicative of physical capacity. Considering the described developments, exercise programs focused on spinal stabilization in individuals with amputation are becoming a serious alternative in clinical practice., (Copyright © 2024 International Society for Prosthetics and Orthotics.)

Background: Adolescent idiopathic scoliosis (AIS) is the most common vertebral disorder in adolescence., Objectives: The purpose of this study was to compare the effectiveness of Schroth and Lyon exercise methods on Cobb angle (CA), angle of trunk rotation (ATR), quality of life (QoL), and perceived trunk appearance in patients with AIS., Methods: The 31 participants diagnosed (diagnosis age = 12.2 ± 0.9) with AIS by a physician following the Lenke criteria and subsequently referred to the outpatient clinic were enrolled in the study. All participants were randomly assigned between the Schroth group (SG) and Lyon group (LG) for 6 months of supervised and home treatment. The participants' CA, ATR, Scoliosis Research Society-22 (SRS-22), and Walter-Reed Visual Assessment Scale (WRVAS) were assessed as a baseline, and again following the treatment by the same researcher who remained blinded to the study., Results: In 2-way mixed-design repeated-measures ANOVA analysis, when the change in time was analyzed between the groups (Group × Time [interaction]), a statistical difference was found more significant in SG for the CA-thoracic (F = 103.1, p < .01, 95% CI = 4.1; 2.0 to 6.2), CA-lumbar (F = 19.1, p < .01, 95% CI = 1.7; 1.0 to 2.4), ATR (F = 64.1, p < .01, 95% CI = 1.7; 1.2 to 2.3), and WRVAS (F = 169.5, p < .01, 95% CI = 6.5; 3.2 to 9.9) parameters. The LG was only more significantly improved in the SRS-22 total score (F = 15.7, p < .01, 95% CI = -0.9; -0.2 to -1.6)., Conclusion: In the study, The Schroth exercises gave more favorable results than Lyon exercises in terms of CA-T, CA-L, ATR and WRVAS in the conservative treatment of AIS, while Lyon exercises gave more favorable results in terms of QoL. Additionally, according to the results of this study, it was found that the QoL of participants in SG decreased after treatment compared to baseline., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Purpose: The role of thoracolumbar fascia (TLF) in the development of chronic low back pain (CLBP) has growing evidence in the literature. Although CLBP is reported in individuals with idiopathic scoliosis (IS), its relationship with the TLF has yet not been established. This study aims to evaluate the TLF and its relationship with CLBP in IS., Methods: A total of 60 individuals were included in the study. They were divided into three groups as follows: painful scoliosis (n = 20, age: 17.1 ± 3.7 years, Cobb angle: 15-43°), non-painful scoliosis (n = 20, age: 16.4 ± 3.4 years, Cobb angle: 15-45°), and healthy group (n = 20, age: 16.4 ± 4.7 years). Pain was evaluated using the short form of the McGill Pain Questionnaire. TLF thickness was evaluated on the lumbar region using ultrasonography. Trunk range of motion was assessed using a universal goniometer, and flexibility was assessed with sit-and-reach test., Results: The thickness of the right TLF was greatest in the painful group, followed by non-painful (p = 0.007) and healthy (p < 0.001) groups. The thickness of the left TLF in the non-painful and painful groups was greater compared to the healthy group (p < 0.001). In the painful group, right TLF thickness was negatively correlated with trunk flexion/extension (r = -0.540, p = 0.014/r = -0.514, p = 0.020) and left rotation (r = -0.499, p = 0.025) but positively correlated with pain (r = 0.562, p = 0.01)., Conclusions: Thickening of the TLF was observed in IS, whereby, in the presence of CLBP, it was further intensified. We suggest considering fascial thickening as a potential contributing factor to both pain and limited motion in relevant patients., (© 2024. The Author(s).)

Purpose: Virtual reality is widely used in patients with chronic musculoskeletal problems. However, the short-term effects on individuals with transtibial (TT) amputation during this process remain unclear. This study aimed at investigating the effects of virtual reality on rehabilitation outcomes in TT amputees. Methods: The study included 20 TT amputees who were using TT prostheses. The participants were divided into two groups randomly as follows: physiotherapy (PT) and virtual reality (VR). Participants were treated 3 days a week, for 4 weeks, and evaluations were made before and after treatment; a 6-minute walk test was used for performance, a single-leg balance test for balance, Trinity Amputation Prosthesis Experience Scale for prosthesis satisfaction, a 10-meter walking test for gait speed, and a wearable smart t-shirt to determine cadence. Results: It was found that there was a statistically significant difference in performance, balance, prosthesis satisfaction, cadence, and gait speed before and after PT ( P  < 0.05). There were differences in terms of performance, prosthesis satisfaction, balance, cadence, and gait speed before and after VR ( P  < 0.05). There was no statistically significant difference between PT and VR ( P  > 0.05). Conclusion: The 4 weeks of VR training improved performance, prosthesis satisfaction, balance, cadence, and gait speed in TT amputation rehabilitation similar to physiotherapy methods. The addition of VR training to amputation rehabilitation will bring improvements since it is a fun and safe intervention. Clinical Trial Registration: The trial is registered at Clinical Trials.gov, Trial No: NCT03872193.

Introduction: In individuals with transtibial amputation, the distal part of the lower extremity is lost. Therefore, the knee joint is of greater importance to be able to provide physical performance. The aim of this study was to evaluate the correlation between knee joint position sense and physical functional performance in individuals with transtibial amputation., Methods: The study included 21 subjects with transtibial amputation. A digital inclinometer was used to evaluate the joint position sense of the amputated side knee joint. The timed up and go test, the 4-square step test, and 10-m walk test were used to evaluate physical functional performance. Linear regression analysis was used to investigate the associations between independent variables and functional performance tests., Results: The mean age of the participants was 52.52 ± 15.68 years. The mean of the error in knee joint position sense was 5.33 degree (standard deviation = 3.08 degree). The error in knee joint position sense of the amputated limb predicted 45% of the variance in the 4-square step test and 22% of the variance in the 10-m walk test ( P < 0.05)., Conclusions: The knee joint position sense on the amputated side was found to be associated with physical functional performance in individuals with transtibial amputation. Residual limb knee joint position sense should be considered when prescribing prostheses and planning rehabilitation programs., (Copyright © 2023 International Society for Prosthetics and Orthotics.)

Background: Adolescent idiopathic scoliosis (AIS) is the lateral and horizontal deformity of the vertebral column which occurs idiopathically during adolescence. The aim of this study is to identify independent predictors of quality of life in AIS patients., Methods: In total, 31 adolescent patients diagnosed with AIS aged between 10 and 18 years old were included in the study. The scoliosis severity was determined for each patient according to the Cobb method, and their scoliosis perception using the Walter Reed Visual Assessment Scale, a pain assessment was conducted based on the Visual Analog Scale, quality of life using the Scoliosis Research Society-22 questionnaire, and depression level according to the Children's Depression Scale. Multiple Linear Regression analysis was then performed in order to determine the independent determinants of health-related quality of life., Findings: According to the Linear Regression analysis results, children's depression scale, walter reed visual assessment scale, cobb, and anterior trunk rotation explained 52.7% of the variance as independent determinants of SRS-22., Interpretation: The study examined the determinants affecting the quality of life in AIS patients. The results of the study showed that scoliosis severity, perception of cosmetic deformity, degree of rotation, and depression level to be predictors of quality of life in AIS patients. "This trail registered with NCT05242601.", (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Background: Lower limb amputation causes difficulties in mobility together with motor and sensory loss. Challenging situations such as concurrent tasks cause gait parameters to deteriorate. Understanding the effect of concurrent tasks on gait is important for the rehabilitation of amputees., Research Question: Are the effects of concurrent cognitive and motor tasks on gait parameters at fixed speed different in individuals with transtibial amputation, or transfemoral amputation compared to healthy individuals?, Methods: The gait parameters were evaluated of 20 individuals with transtibial amputation, 13 individuals with transfemoral amputation and 20 healthy individuals while walking on a motorized treadmill under single task (ST), cognitive dual task (CDT) and motor dual task (MDT) conditions. The self-selected comfortable velocity, which was determined in the single-task gait, was used in all three walking tests., Results: ST, CDT and MDT gait parameters of individuals with transtibial amputation, transfemoral amputation and healthy individuals were significantly different (p < 0.01). Covariance of step length variability increased in amputees when walking under MDT (p < 0.05). The dual task cost (DTC) for all the gait parameters was similar in all three groups (p > 0.05). The motor DTC of covariance of step length was greater than cognitive DTC (p < 0.05)., Significance: Individuals with lower limb amputation have the capacity to walk with cognitive and motor tasks without changing velocity on the treadmill, but concurrent motor tasks cause an increase in gait variability. The results of this study suggest that there is an increase in gait variability especially with motor tasks, which may cause a higher risk of falling. Trial number: NCT04392466 (clinicaltrials.gov)., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Objectives: To investigate the effects of dual-task balance training on static and dynamic balance, functional mobility, cognitive level, and sleep quality in individuals with transfemoral amputation., Design: Randomized controlled clinical trial., Participants: Transfemoral amputees (N=20)., Interventions: Participants were randomly assigned to the single-task gait and balance training group (n=10) or the dual-task gait and balance training group (n=10). Training was given in sessions of 60 min/d, 3 d/wk for 4 weeks. The single-task training group performed traditional gait and balance exercises, and the dual-task training group practiced cognitive and motor tasks while performing gait and balance exercises., Main Outcome Measures: The 1-leg stance test and the Four Square Step Test were used for balance assessment. The timed Up and Go test and 10-m walk test were used for gait assessment. Three test conditions to evaluate the training effects were single walking, walking while performing a cognitive task (serial subtraction), and walking while performing a motor task (tray carrying). The Montreal Cognitive Assessment scale was used for cognitive assessment and the Pittsburgh Sleep Quality Index for sleep quality assessment., Results: Balance and mobility improved in both groups. Dual-task balance performance, functional mobility, and gait speed improved more in the dual-task training group after training (P<.05). Cognitive status and sleep quality improved significantly in the dual-task group (P<.05)., Conclusions: Dual-task training was more effective than single-task training in the improvement of dual-task performance and cognitive status. The inclusion of dual-task exercises in the rehabilitation program of transfemoral amputees will provide a different perspective because of increased task automation., (Copyright © 2020 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.)

Background/aim: Although mirror therapy (MT) and phantom exercises (PE) have been shown to reduce pain, the efficacy of these methods in terms of pain, quality of life (QoL), and psychological status (PS) has not been investigated and compared to date. The aim of this study was to determine whether there is any difference between MT and PE in the treatment of phantom limb pain (PLP)., Materials and Methods: Forty unilateral transtibial amputees (aged 18–45 years) participated in this study. The subjects were randomly divided into ‘MT group’ and ‘PE group’. QoL was assessed using Short-Form 36 (SF-36), psychological status using the Beck depression inventory (BDI), and pain intensity using a visual analog scale (VAS), before and at the end of the program, and on the 3rd and 6th months thereafter., Results: All assessments for all parameters improved significantly in both groups (P < 0.05). Comparison of the two groups revealed a significant difference in changes for VAS and BDI in all measurements, and in pre- and posttreatment scores for all SF-36 parameters (except for Role-Emotional) in favor of the MT group (P < 0.05)., Conclusion: While pain intensity decreased and QoL and PS improved in both the MT and PE groups, these improvements were greater in the MT group.

Background/aim: A few studies have been carried out in lower limb amputees (LLAs) and they examined the incidence of and reasons for low back pain. The aim of this study was to assess the effectiveness of a back school program in LLAs with mechanical low back pain (MLBP)., Materials and Methods: Forty male unilateral transfemoral amputees with MLBP were randomly allocated into two groups. A back school program was applied to Group 1 over 2 weeks. A booklet for home use was given to each participant in Group 2. Pain was assessed using a visual analogue scale. Spinal flexibility measurements were obtained. For the assessment of back pain-related disability, the Oswestry Disability Index was used. Patients were assessed at baseline, at month 1, and at month 3., Results: At the month 1 assessment, a reduction in pain intensity and disability, and increase in spinal flexibility measurements were detected in Group 1 only (P < 0.05). At the month 3 assessment, there were improvements in all measured parameters in both groups(P < 0.05). Group 1 had better results in all parameters compared with Group 2., Conclusion: The back school program, combined with an exercise program, decreased pain and disability and improved the spinal flexibility significantly in LLAs with MLBP.

Objective: The aim of this study was to evaluate the functional level of children with congenital and acquired upper limb loss after a rehabilitation program., Methods: This study included a total of 40 children, aged 8 to 17 years with upper limb loss. Children were divided into two groups; congenital amputees (n=20) and acquired amputees (n=20). The children underwent prosthetic fitting, prosthetic training and rehabilitation. The Child Amputee Prosthetics Project - Functional Status Inventory (CAPP-FSI) and Prosthetic Upper Extremity Functional Index (PUFI) were used at the initial visit to the prosthetic unit without prosthesis, 3 weeks after the prosthetic training and 6 months after discharge with and without prosthesis. The results with and without the prosthesis were compared between the acquired and congenital amputee groups., Results: There were significant differences in all tests performed at the baseline, at the 3rd week, and at the 6th month without prosthesis and at the 3rd week and at the 6th month with prosthesis (p<0.05). The congenital group received higher scores in the CAPP-FSI and PUFI at the baseline, at the 3rd week and at the 6th month (p<0.05). Patients in the congenital group used their prostheses for 8 hours a day and the acquired group for 4 to 8 hours., Conclusion: Daily prosthesis usage time and the child's experience with the prosthesis during daily activities are the determining factors for the functional level in upper limb child amputees. Functionality may improve based on these factors.

The purpose of this study was to assess whether reaction time in persons with intellectual disabilities can be improved with an exercise program. 50 children and adolescents (M age = 14.7 yr., SD = 1.4, range = 11-18) with mild intellectual disability without Downs syndrome were randomly divided into control (20 boys, 5 girls) and experimental (19 boys, 6 girls) groups. The experimental group participated in a structured physical fitness program for 12 weeks. Reaction time was assessed at baseline and after 12 weeks. Significant improvements in reaction time were observed in the exercise group but not for the control group. Results indicated that reaction time can be improved with an exercise program in youth with intellectual disability.

This study was designed to compare the parameters of reaction time on mentally retarded and healthy children and also to find out the effect of sport on reaction time. The study consisted of 20 non-retarded (group I), 20 non-sporting trainable mentally retarded (group II), and 20 sporting trainable mentally retarded (group III). The avarage age of subjects were determined as 15.35 +/- 0.21 years in group I, 15.00 +/- 0.22 years in group II, and 15.15 +/- 0.21 years in group III. The audiovisual reaction time of both non-retarded and retarded children were measured. It was found that reaction time is lower in trainable mentally retarded children (p < 0.05). It can be concluded that sport is a valid and effective means of training which affects the reaction time positively.