The effect of a supervised community-based exercise program on balance, balance confidence, and gait in individuals with lower limb amputation

Prosthet Orthot Int. 2017 Oct;41(5):446-454. doi: 10.1177/0309364616683818. Epub 2017 Jan 9.


Background: Many individuals with lower limb loss report concern with walking ability after completing structured traditional rehabilitation.

Objectives: The purpose of this study was to explore the impact of a supervised community-based exercise program on balance, balance confidence, and gait in individuals with lower limb amputation.

Study design: Repeated measures.

Methods: The supervised exercise program was offered biweekly for 6 weeks. The GAITRite System by CIR Systems, Inc., the Figure-of-8 Walk Test, and Activity-specific Balance Confidence Scale were used to measure clinical outcomes pre- and post-intervention.

Results: In total, 16 participants with lower limb amputation (mean age: 50.8 years) completed the study. A multivariate, repeated measures analysis of variance indicated a statistically significant effect of training across six clinical outcome measures ( F(6, 10) = 4.514, p = .018). Moderate effect sizes were found for the Figure-of-8 Walk Test ( η2 = .586), Activity-specific Balance Confidence Scale ( η2 = .504), and gait velocity at comfortable walking speed ( η2 = .574). The average increase in gait speed was clinically meaningful at .14 m/s.

Conclusion: The supervised community-based exercise program implemented in this study was designed to address specific functional needs for individuals with lower limb loss. Each participant experienced clinically meaningful improvements in balance, balance confidence, and walking ability. Clinical relevance The provision of a supervised community-based exercise program, after traditional rehabilitation, provides opportunity to offer a continuum of care that may enhance prosthetic functional ability and active participation in the community for individuals with lower limb amputation.

Keywords: Rehabilitation of prostheses users; balance and balance confidence; community-based exercise; gait; rehabilitation.

Publication types

  • Comparative Study

MeSH terms

  • Activities of Daily Living*
  • Adult
  • Aged
  • Amputation, Surgical / methods
  • Amputation, Surgical / rehabilitation*
  • Amputees / rehabilitation*
  • Artificial Limbs
  • Cohort Studies
  • Community Health Services / organization & administration
  • Exercise Therapy / organization & administration*
  • Female
  • Gait / physiology*
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Patient Selection
  • Postural Balance / physiology*
  • Program Evaluation
  • Prospective Studies
  • Quality of Life
  • Treatment Outcome
  • United States