The effect of weight-bearing training with visual feedback on balance and prosthetic loading in trans-tibial amputees following vascular disease - a pilot randomized control trial.

PURPOSE: Asymmetrical weight-bearing on trans-tibial prosthesis at the initial prosthetic fitting results in a modified gait and secondary disorders. The pilot study will examine the feasibility of the weight-bearing training with visual feedback in trans-tibial prosthesis loading and its potential effectiveness. METHODS: Weight-bearing of the prosthesis was evaluated by centre of pressure (COP). Twenty participants with unilateral initial trans-tibial prosthesis were randomized into test and control group; the control received conventional rehabilitation training; the test group weight-bearing training with real-time feedback in 10 sessions over 2 weeks. Clinical tests 10 m walk test and L-Test were carried out in both groups at baseline and after 2 weeks. RESULTS: Statistical differences were found between the groups in COP postural sway and frontal plane COP sway path (p < 0.05). The maximal movement in the frontal plane in the test group substantially decreased indicating improvement in loading of the prosthesis. The clinical tests demonstrated significant improvement in both groups (p < 0.001). CONCLUSIONS: The differences in pre-post changes of the intervention demonstrated changes in medial-lateral weight transfer and thus loading of the prosthesis after the weight-bearing training program with visual feedback. Values were sufficiently large and meaningful to pursue a larger clinical trial for suggested initial fitting of trans-tibial prosthesis.