How People With Lower-Limb Loss Can Improve Gait Through Exercise
Even after finishing a rehabilitation program, more than 50% of individuals with lower limb loss still experience falls. This significantly affects their quality of life, so finding ways to improve their walking ability is crucial.
A previous review found that specific exercise interventions improved gait and balance. However, it did not distinguish between the various phases of rehabilitation:
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The Subacute Phase or “the early stage” – following amputation surgery.
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The Chronic Phase or “the later stage” – consists of continued medical, prosthetic, functional, and emotional care to meet long-term goals.
So, researchers sought to find out if the timing of the exercise interventions can improve walking ability. They also sought to determine what exercise intervention led to significant improvement.
The review
The new systematic review, published in Prosthetics and Orthotics International in April 2024, analyzed 16 studies. One study focused on Hip Abductor Strengthening and another on Treadmill Gait Training. Meanwhile, the remaining 14 studies evaluated Multicomponent Exercise programs, consisting of static and dynamic balance, stretching, strength, aerobic, and gait training.
In all studies, the strength training and stretching exercises under the multicomponent program focused primarily on the muscles of the lower limb, whereas two studies also included strengthening the trunk.
Three studies focused on proprioceptive neuromuscular facilitation (PNF) techniques, which are used to improve muscle elasticity and range of motion. Meanwhile, three studies examined the use of exercise-based video games to deliver the exercise program.
Results
The researchers found that the Multicomponent Exercise Program led to significant improvements in walking in both the early and later stages of rehabilitation. These programs were effective even when progress in daily functioning slowed down in the later stage.
The researchers also discovered that adding Dual-Task Training to a multicomponent program helped people with lower limb loss coordinate their movements. Dual-task training was beneficial because people often do more than one thing at a time while walking in their daily lives. Without this type of training, individuals with lower limb loss faced greater mental demands, which made walking harder for them.
In addition to Dual-task training, the researchers discovered that Virtual Reality Training was effective. VR training uses technology to track a person’s movements and use them to control a character in a video game. People with lower limb loss can benefit from this type of training because it provides sensory feedback through sight, sound, and physical sensation, which can improve their ability to learn and perform physical activities.
The bottom line
This systematic review demonstrates the effectiveness of Multicomponent Exercise Programs with a focus on balance training, strength training, stretching, and gait training in improving how individuals with lower limb loss walk.
The research also emphasizes that these programs are beneficial in both the early and late stages of rehabilitation. Additionally, including Dual-Task Training and Virtual Reality Training have shown promise in enhancing coordination ability and providing sensory feedback to improve gait.
If you’re currently undergoing rehabilitation and are discouraged by a plateau in either the early or late phases, these findings offer hope that modifying your program, may lead to improvements and breaking through your plateau.
