Akademik Veri Yönetim Sistemi
PROSTHETICS AND ORTHOTICS INTERNATIONAL, cilt.0, sa.0, ss.1-8, 2024 (SCI-Expanded)
Background: In some cultures, shoes are not worn indoors. Prosthesis use barefoot can lead to pressure injuries and loss of
balance due to abnormal residual limb loading.
Objective: This study aimed to compare the effect of wearing standard alignment prostheses using barefoot at home and visual
alteration on static balance and pressure distribution in individuals with unilateral transfemoral amputations (TFAs) or transtibial
amputations (TTAs).
Study design: Prospective parallel experimental study.
Methods: Participants with unilateral TTAs (n 5 44) and TFAs (n 5 37) were included. Balance and load distribution were assessed
using MatScan pressure platforms, both with a heel (3 32 cm2 area; 1.8 cm height) support (the use of shoes with a heel is mimicked)
and barefoot.
Results: Balance parameters were disrupted in all groups when eyes closed position (p , 0.05). Using heels reduced anteriorposterior
and medial-lateral sway in TTA group during eyes closed (p,0.05). When standing barefoot with the eye open position, TFA
group had more load on the rear foot of the prosthetic foot and less load on the forefoot than TTA group (p , 0.05). The opposite
pattern was observed in the intact foot (p,0.05). Using heels in TTA group increased the load on the front of the intact side and the rear
of the prosthetic side (p , 0.05).
Conclusion: The balance parameters were impaired in both groups while standing barefoot in the absence of vision. However, using
heel supports improved static balance in the TTA but not in the TFA group. Using heel support changed this load distribution in both
groups, especially in the TTAs, and created positive changes.
Keywords
amputee, barefoot, heel, center of pressure, transtibial, transfemoral