Use of Perturbation-Based gait training in a virtual environment to address mediolateral instability in an individual with unilateral transfemoral amputation

Riley C. Sheehan, Christopher A. Rábago, Jonathan H. Rylander, Jonathan Dingwell, Jason M. Wilken

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background and Purpose. Roughly 50% of individuals with lower limb amputation report a fear of falling and fall at least once a year. Perturbation-based gait training and the use of virtual environments have been shown independently to be effective at improving walking stability in patient populations. An intervention was developed combining the strengths of the 2 paradigms utilizing continuous, walking surface angle oscillations within a virtual environment. This case report describes walking function and mediolateral stability outcomes of an individual with a unilateral transfemoral amputation following a novel perturbation-based gait training intervention in a virtual environment. Case Description. The patient was a 43-year-old male veteran who underwent a right transfemoral amputation 7+ years previously as a result of a traumatic blast injury. He used a microprocessor-controlled knee and an energy storage and return foot. Outcomes. Following the intervention, multiple measures indicated improved function and stability, including faster self-selected walking speed and reduced functional stepping time, mean step width, and step width variability. These changes were seen during normal level walking and mediolateral visual field or platform perturbations. In addition, benefits were retained at least 5 weeks after the final training session. Discussion. The perturbation-based gait training program in the virtual environment resulted in the patient’s improved walking function and mediolateral stability. Although the patient had completed intensive rehabilitation following injury and was fully independent, the intervention still induced notable improvements to mediolateral stability. Thus, perturbationbased gait training in challenging simulated environments shows promise for improving walking stability and may be beneficial when integrated into a rehabilitation program.

Original languageEnglish (US)
Pages (from-to)1896-1904
Number of pages9
JournalPhysical Therapy
Volume96
Issue number12
DOIs
StatePublished - Dec 1 2016

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Gait
Amputation
Walking
Rehabilitation
Accidental Falls
Blast Injuries
Microcomputers
Veterans
Visual Fields
Fear
Foot
Lower Extremity
Knee
Education
Wounds and Injuries
Population

All Science Journal Classification (ASJC) codes

  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

Sheehan, Riley C. ; Rábago, Christopher A. ; Rylander, Jonathan H. ; Dingwell, Jonathan ; Wilken, Jason M. / Use of Perturbation-Based gait training in a virtual environment to address mediolateral instability in an individual with unilateral transfemoral amputation. In: Physical Therapy. 2016 ; Vol. 96, No. 12. pp. 1896-1904.
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Use of Perturbation-Based gait training in a virtual environment to address mediolateral instability in an individual with unilateral transfemoral amputation. / Sheehan, Riley C.; Rábago, Christopher A.; Rylander, Jonathan H.; Dingwell, Jonathan; Wilken, Jason M.

In: Physical Therapy, Vol. 96, No. 12, 01.12.2016, p. 1896-1904.

Research output: Contribution to journalArticle

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