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Effects of Upper Limb Loss or Absence and Prosthesis Use on Postural Control of Standing Balance.

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Effects of Upper Limb Loss or Absence and Prosthesis Use on Postural Control of Standing Balance.

Auteurs : Matthew J. Major ; Rebecca Stine ; Tara Shirvaikar ; Steven A. Gard

Source :

RBID : pubmed:31688013

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English descriptors

Abstract

OBJECTIVE

Persons with upper limb loss or absence experience a high prevalence of falls. Although upper limb prostheses help perform upper limb tasks, fall likelihood increases by six times with prosthesis use. The effects of upper limb loss or absence and prosthesis use on postural control are poorly documented.

DESIGN

Static posturography characterized postural control of standing balance between persons with unilateral upper limb loss or absence not wearing a prosthesis and wearing either a customary prosthesis or prosthesis that matched the mass, inertia, and length of their sound limb. Able-bodied controls were also compared to persons with unilateral upper limb loss or absence not wearing a prosthesis. Center-of-pressure anterior-posterior range, medial-lateral range, and sway area, as well as weight-bearing symmetry, were measured.

RESULTS

Persons with upper limb loss or absence display greater standing postural sway than controls. Although wearing a prosthesis improved weight-bearing symmetry, this condition increased postural sway, which was pronounced in the medial-lateral direction.

CONCLUSIONS

The presence of upper limb loss or absence increased postural control demands than able-bodied individuals as reflected in greater postural sway, which was further exacerbated with the use of prosthesis. Results suggest that upper limb loss or absence and prosthesis use may affect the internal models that guide motor commands to maintain body center-of-mass position equilibrium. The relatively greater postural control demands might help explain the increase fall prevalence in this patient group.


DOI: 10.1097/PHM.0000000000001339
PubMed: 31688013

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Matthew J. Major
<affiliation>
<nlm:affiliation>From the Jesse Brown VA Medical Center, Chicago, Illinois (MJM, RS, SAG); and Northwestern University Prosthetics-Orthotics Center, Department of Physical Medicine & Rehabilitation, Feinberg School of Medicine, Chicago, Illinois (MJM, TS, SAG).</nlm:affiliation>
<wicri:noCountry code="subField">SAG)</wicri:noCountry>
</affiliation>

Le document en format XML

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<title xml:lang="en">Effects of Upper Limb Loss or Absence and Prosthesis Use on Postural Control of Standing Balance.</title>
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<name sortKey="Major, Matthew J" sort="Major, Matthew J" uniqKey="Major M" first="Matthew J" last="Major">Matthew J. Major</name>
<affiliation>
<nlm:affiliation>From the Jesse Brown VA Medical Center, Chicago, Illinois (MJM, RS, SAG); and Northwestern University Prosthetics-Orthotics Center, Department of Physical Medicine & Rehabilitation, Feinberg School of Medicine, Chicago, Illinois (MJM, TS, SAG).</nlm:affiliation>
<wicri:noCountry code="subField">SAG)</wicri:noCountry>
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<name sortKey="Stine, Rebecca" sort="Stine, Rebecca" uniqKey="Stine R" first="Rebecca" last="Stine">Rebecca Stine</name>
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<author>
<name sortKey="Shirvaikar, Tara" sort="Shirvaikar, Tara" uniqKey="Shirvaikar T" first="Tara" last="Shirvaikar">Tara Shirvaikar</name>
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<name sortKey="Gard, Steven A" sort="Gard, Steven A" uniqKey="Gard S" first="Steven A" last="Gard">Steven A. Gard</name>
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<title xml:lang="en">Effects of Upper Limb Loss or Absence and Prosthesis Use on Postural Control of Standing Balance.</title>
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<name sortKey="Major, Matthew J" sort="Major, Matthew J" uniqKey="Major M" first="Matthew J" last="Major">Matthew J. Major</name>
<affiliation>
<nlm:affiliation>From the Jesse Brown VA Medical Center, Chicago, Illinois (MJM, RS, SAG); and Northwestern University Prosthetics-Orthotics Center, Department of Physical Medicine & Rehabilitation, Feinberg School of Medicine, Chicago, Illinois (MJM, TS, SAG).</nlm:affiliation>
<wicri:noCountry code="subField">SAG)</wicri:noCountry>
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<name sortKey="Stine, Rebecca" sort="Stine, Rebecca" uniqKey="Stine R" first="Rebecca" last="Stine">Rebecca Stine</name>
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<name sortKey="Shirvaikar, Tara" sort="Shirvaikar, Tara" uniqKey="Shirvaikar T" first="Tara" last="Shirvaikar">Tara Shirvaikar</name>
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<keywords scheme="KwdEn" xml:lang="en">
<term>Amputees (MeSH)</term>
<term>Arm (MeSH)</term>
<term>Artificial Limbs (MeSH)</term>
<term>Female (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Male (MeSH)</term>
<term>Middle Aged (MeSH)</term>
<term>Postural Balance (physiology)</term>
<term>Standing Position (MeSH)</term>
<term>Weight-Bearing (MeSH)</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr">
<term>Adulte d'âge moyen (MeSH)</term>
<term>Amputés (MeSH)</term>
<term>Bras (MeSH)</term>
<term>Femelle (MeSH)</term>
<term>Humains (MeSH)</term>
<term>Membres artificiels (MeSH)</term>
<term>Mise en charge (MeSH)</term>
<term>Mâle (MeSH)</term>
<term>Position debout (MeSH)</term>
<term>Équilibre postural (physiologie)</term>
</keywords>
<keywords scheme="MESH" qualifier="physiologie" xml:lang="fr">
<term>Équilibre postural</term>
</keywords>
<keywords scheme="MESH" qualifier="physiology" xml:lang="en">
<term>Postural Balance</term>
</keywords>
<keywords scheme="MESH" xml:lang="en">
<term>Amputees</term>
<term>Arm</term>
<term>Artificial Limbs</term>
<term>Female</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Standing Position</term>
<term>Weight-Bearing</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr">
<term>Adulte d'âge moyen</term>
<term>Amputés</term>
<term>Bras</term>
<term>Femelle</term>
<term>Humains</term>
<term>Membres artificiels</term>
<term>Mise en charge</term>
<term>Mâle</term>
<term>Position debout</term>
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<front>
<div type="abstract" xml:lang="en">
<p>
<b>OBJECTIVE</b>
</p>
<p>Persons with upper limb loss or absence experience a high prevalence of falls. Although upper limb prostheses help perform upper limb tasks, fall likelihood increases by six times with prosthesis use. The effects of upper limb loss or absence and prosthesis use on postural control are poorly documented.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>DESIGN</b>
</p>
<p>Static posturography characterized postural control of standing balance between persons with unilateral upper limb loss or absence not wearing a prosthesis and wearing either a customary prosthesis or prosthesis that matched the mass, inertia, and length of their sound limb. Able-bodied controls were also compared to persons with unilateral upper limb loss or absence not wearing a prosthesis. Center-of-pressure anterior-posterior range, medial-lateral range, and sway area, as well as weight-bearing symmetry, were measured.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>RESULTS</b>
</p>
<p>Persons with upper limb loss or absence display greater standing postural sway than controls. Although wearing a prosthesis improved weight-bearing symmetry, this condition increased postural sway, which was pronounced in the medial-lateral direction.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>CONCLUSIONS</b>
</p>
<p>The presence of upper limb loss or absence increased postural control demands than able-bodied individuals as reflected in greater postural sway, which was further exacerbated with the use of prosthesis. Results suggest that upper limb loss or absence and prosthesis use may affect the internal models that guide motor commands to maintain body center-of-mass position equilibrium. The relatively greater postural control demands might help explain the increase fall prevalence in this patient group.</p>
</div>
</front>
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<AbstractText Label="OBJECTIVE">Persons with upper limb loss or absence experience a high prevalence of falls. Although upper limb prostheses help perform upper limb tasks, fall likelihood increases by six times with prosthesis use. The effects of upper limb loss or absence and prosthesis use on postural control are poorly documented.</AbstractText>
<AbstractText Label="DESIGN">Static posturography characterized postural control of standing balance between persons with unilateral upper limb loss or absence not wearing a prosthesis and wearing either a customary prosthesis or prosthesis that matched the mass, inertia, and length of their sound limb. Able-bodied controls were also compared to persons with unilateral upper limb loss or absence not wearing a prosthesis. Center-of-pressure anterior-posterior range, medial-lateral range, and sway area, as well as weight-bearing symmetry, were measured.</AbstractText>
<AbstractText Label="RESULTS">Persons with upper limb loss or absence display greater standing postural sway than controls. Although wearing a prosthesis improved weight-bearing symmetry, this condition increased postural sway, which was pronounced in the medial-lateral direction.</AbstractText>
<AbstractText Label="CONCLUSIONS">The presence of upper limb loss or absence increased postural control demands than able-bodied individuals as reflected in greater postural sway, which was further exacerbated with the use of prosthesis. Results suggest that upper limb loss or absence and prosthesis use may affect the internal models that guide motor commands to maintain body center-of-mass position equilibrium. The relatively greater postural control demands might help explain the increase fall prevalence in this patient group.</AbstractText>
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