Henness D, Medema A, Steinhorst K, Moauro R, Reuland M, Whelan R, Kester S, Bateni H. CHANGES IN POSTURAL STEADINESS FOLLOWING TRANS-TIBIAL AMPUTATIONS. 
CANADIAN PROSTHETICS & ORTHOTICS JOURNAL, VOLUME 1, ISSUE 2, 2018; ABSTRACT, POSTER PRESENTATION AT THE AOPA’S 101ST NATIONAL ASSEMBLY, SEPT. 26-29, 
VANCOUVER, CANADA, 2018. DOI: https://doi.org/10.33137/cpoj.v1i2.32014                                                              

 

1 

 
OPEN  ACCESS 

 

AOPA’S 101 ST NATIONAL ASSEMBLY ABSTRACTS, SEPTEMBER 26-29, VANCOUVER, CANADA, 2018 
 

ABSTRACT (POSTER PRESENTATION) 

CHANGES IN POSTURAL STEADINESS FOLLOWING TRANS-TIBIAL 

AMPUTATIONS 

Douglas Henness, Arianna Medema, Kendra Steinhorst, Robert Moauro, Michael Reuland, Robert Whelan, 

Shawna Kester, Hamid Bateni*  

Physical Therapy Program, Northern Illinois University, DeKalb, IL, USA. 

*Email: hbateni@niu.edu 

DOI: https://doi.org/10.33137/cpoj.v1i2.32014 
 

INTRODUCTION 

Increased risk of falling following amputation is well 

documented in literature1. As the amputee population 

ages, accidental falls become a greater problem. Trans- 

tibial amputations are one of the most common levels of 

amputation. We hypothesized that postural steadiness is 

deteriorated following trans-tibial amputation as 

compared to age matched younger adults.  

METHODS 

Data from three trans-tibial amputees (51±16 years old) 

and six healthy age matched (48±19 year old) were 

analyzed. Participants were instructed to stand (bare feet 

- heels together, 5-7 degrees toe-out) on a force platform 

and were tested for three standing conditions: a- eyes 

open, b- eyes closed and c- standing on Airex 2.5” thick 

balance pad (www.airex.com). Each test was repeated 

three times (block randomized). Force platform data 

were collected for 35 seconds. Anteroposterior and 

mediolateral time series data were filtered through a 

fourth-order zero phase Butterworth low-pass filter with 

cut-off frequency of 5 Hz. The first 8 sec. and last 2 sec. 

of data were cut off to remove any potential lead-in/out 

effect.  

RESULTS 

Analysis of variance on time and frequency domain 

variables of sway indicated significant differences 

among amputees vs. non-amputees. Mean mediolateral 

sway distance and the standing conditions were 

significantly different (F(1,5)=5.83, p<0.05 and 

F(1,5)=3.84,, p<0.05 respectively). The maximum ml 

sway velocity was also affected by amputation 

(F(1,5)=17.66,, p<0.0001). In frequency domain 

variables, Power in ml direction was both affected by 

amputation (F(1,5)=10.66, p<0.001) and test condition 

(F(1,5)=4.16, p=0.019). 95% AP power frequency and 

centroidal frequency were also affected by amputation 

(p=0.013 and 0.003 respectively). 

 

 

 

Figure 1. comparison of ML postural sway of amputees 

(YAMP) and non-amputees (NAMP) for three standing 

conditions of 1 (eyes open), 2(eyes closed) and 3 (standing on 

foam). Horizontal cross line indicated median and diamond 

shape indicates mean value of the data. 

CONCLUSION 

Our results indicate that postural steadiness is altered 

following amputation both in time and frequency 

domain.  

SIGNIFICANCE 

Assessment of postural steadiness in both time and 

frequency domain can reveal a new aspect in assessment 

of balance and postural control among amputees and can 

lead to more effective training exercises as well as 

optimizing prosthetic component designs to reduce 

accidental fall among this population.  

REFERENCES 

1- C. Gauthier-Gagnon, M. C. Grise, and D. Potvin, Enabling 

factors related to prosthetic use by people with transtibial and 

transfemoral amputation. Arch. Phys. Med. Rehabil. 1999; 

vol. 80, pp. 706–713.   

DISCLOSURE 

No conflict of interest exists for this study. 

mailto:hbateni@niu.edu
https://doi.org/10.33137/cpoj.v1i2.32014