Unilateral Trans-tibial Amputees Clinical Trial
Official title:
Hull - Early Walking Aids for Transtibial Amputees - Does an Articulated Knee Have Benefits? A Randomised Controlled Trial
Early walking aids are routinely used in UK for rehabilitation of patients with below knee amputations. The two main walking aids used commonly in practice include the non-articulated Pneumatic Post Amputation Mobility Aid (PPAM)and the Articulated Amputee Mobility Aid (AMA). There is no published evidence on whether the articulated walking aid improves knee control and shortens delivery time. This study was designed to test the hypothesis that an articulated early walking aid has benefit to transtibial amputee compared to non-articulated early walking aid.
Physiotherapists in the UK routinely use Early Walking Aids (EWA's) to enable the lower limb
amputee to start to walk again as early as 5 days post amputation (Lein S. 1992). An EWA has
many benefits including a reduction in oedema (Reith et al, 1992) early gait and balance
training in preparation for using a prosthesis. The two EWA's most commonly used in the UK
for transtibial amputees are the Pneumatic Post Amputation Mobility aid (PPAM) and the
Amputee Mobility Aid (AMA). A comparison of the PPAM aid and the AMA undertaken by Longmore T
(1997) reported no significant difference in energy cost, comfort or ease of use. Scott et al
(2000) found the AMA to have higher interface pressures than the PPAM aid. There is however
no known published evidence on whether an articulated EWA improves active knee control
following prosthetic delivery and therefore shortens rehabilitation time. In addition there
is no known published evidence of the effect on quality of life with the two different EWA's.
Hypothesis: An articulated Early walking aid has benefit to the transtibial amputee compared
to a non- articulated EWA.
The purpose of this proposed research is to investigate whether there are any benefits to
patients in using an articulated EWA.
The study will use EMG and gait analysis to determine the potential of each of the two EWA's
to re-educate gait in a way that is comparable with the gait exhibited when the subject
subsequently begins to use a prosthesis thus shortening rehabilitation time. Quality of life
indicators will be used to determine the impact on the patient and, in addition, the length
of time taken to full rehabilitation will be considered.
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