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    Comparison of gait variability and symmetry in trained individuals with transtibial and transfemoral limb loss
    (Sage Publications Ltd, 2019) Keklicek, Hilal; Kirdi, Elif; Yalcin, Ali; Topuz, Semra; Ulger, Ozlem; Erbahceci, Fatih; Sener, Gul
    Purpose: Gait variability is a determinant of qualified locomotion and is useful for monitoring the effects of therapeutic interventions. The aim of this study was to compare gait variability and symmetry in trained individuals with transtibial (TT) amputation and transfemoral (TF) amputation. Methods: The design of this study was planned as observational. Eleven individuals with TF amputation, 14 individuals with TT amputation, and 14 healthy individuals (HI) were evaluated with a motorized treadmill. The mean step length, the step length variability, an ambulation index, and the time on each foot (stance phase symmetry) of participants were recorded. Results: There were differences between the three groups in the residual/non-preferred limb (RNp) step length (p = 0.031), the intact/preferred (IP) limb step length variability (p = 0.001), the RNp step length variability (p < 0.001), the time on each foot (p < 0.001), and the ambulation index score (p < 0.001). There was a similarity between the groups (TF, TT, HI) in IP limb step lengths (p = 0.127) and duration of prosthesis usage since amputation in individuals with lower limb loss (p = 0.224). Conclusions: This study provided basic data about gait variability and symmetry in individuals with traumatic lower limb loss. The results of the study showed that the variability of gait increased with the level of loss, and individuals with TT amputation showed partially equivalent performance with the healthy group. Similarities in gait characteristics may have resulted from effective prosthetic usage or effective gait rehabilitation.
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    Effects of arm swing on spatiotemporal characteristics of gait in unilateral transhumeral amputees
    (Elsevier Ireland Ltd, 2019) Topuz, Semra; Kirdi, Elif; Yalcin, Ali Imran; Ulger, Ozlem; Keklicek, Hilal; Sener, Gul
    Background: Gait is an autonomic process consisting of coordinated movements of the upper extremities, lower extremities, trunk and pelvis. However, researches regarding effects of upper extremity problems on gait parameters are limited. Research question: The aim of this study was to investigate the effects of arm swing on spatiotemporal characteristics of gait in individuals with unilateral transhumeral amputations. Methods: A total of 25 unilateral transhumeral amputees and 25 healthy subjects were included. Information on the demographic features of individuals, amputations, and prosthetic devices were recorded. Spatiotemporal characteristics of gait were obtained using the GAITRite electronic walkway, and the arm swing was evaluated with the two video-cameras and analyzed using the Dartfish Pro Suite 7 software. Results: The groups were similar regarding their age, height and weight. Mean duration from the amputation was 14.91 +/- 10.90 years, and the mean weight of the prostheses was 1.44 +/- 0.39 kg. Amputees had a less ambulatory arm swing on their amputated sides compared to their intact arms and healthy individuals. When the amputee group was compared to the healthy individuals, their step and stride lengths were shorter and their foot progression angle was higher, their gait velocity and cadence were lower than the healthy group. Significance: The reduction of arm swing on the amputated side in unilateral transhumeral amputees is thought to be due to (1) use of the contralateral side in functional activities, (2) restriction of shoulder joint movement of socket boundaries and (3) fixed mechanical elbow joint. It has been thought that a decrease in the arm swing during walking may lead to a decrease in step length, stride length, and gait velocity.
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    The Effects of Instrumental Balance Training on Balance in Individuals with Unilateral Transtibial Amputation: A Pilot Study
    (Lippincott Williams & Wilkins, 2023) Kirdi, Elif; Yalcin, Ali; Keklicek, Hilal; Topuz, Semra; Ulger, Ozlem; Yazicioglu, Gul
    IntroductionWith the loss of a lower limb, an individual with amputation may face impaired gait and balance. Different rehabilitation techniques can be used to deal with those functional disabilities. The purpose of this study was to determine whether computerized balance training could have any possible effects on balance in individuals with unilateral transtibial amputation.Materials and MethodsA total of 16 subjects who used a prosthesis in their daily life and were between 18 and 65 years of age were included in the study. Individuals were randomly divided into two groups: control group (CG) (n = 7) trained with traditional prosthetic rehabilitation and the experimental group (EG) (n = 9) trained with computerized balance training for five sessions for 2 weeks. Percentage of prosthetic weight bearing (PWB) timed up and go test (TUG), single-leg stance test (SLST), postural sway score, and limits of stability (LoS) were evaluated at baseline and posttreatment.ResultsNo significant differences were observed in between-group comparisons after treatment. Within-group comparison showed that PWB, SLST, and LoS score increased in EG, whereas only PWB increased in CG.ConclusionsSimilar results were revealed with both computerized and traditional prosthetic training. Although there were no significant differences in between-group comparisons, computerized balance training improved the amputated side single-leg stance and stability limits, which are highly related to fall risk in individuals with amputation.