Subsensory stimulation and visual/auditory biofeedback for balance control in amputees

In this study, we hypothesized that the static standing weight bearing steadiness and dynamic walking weight shifting stability could be improved by providing neuromuscular facilitation using subsensory stimulation and visual-auditory biofeedback in amputee respectively. To test this hypothesis, a computer protocol with sensory feedback neuromuscular facilitation system was developed and used for clinical assessment. Seven unilateral transtibial amputees who consecutively worn prosthetics over two years were recruited. Experimental results show a reduction in all of the postural sway related indices and increase in single-leg holding time index during static quiet standing by applying subsensory stimulation. With visual-auditory biofeedback for providing clue for heel contact and toe push-off condition during dynamic ambulation, an improvement in all four dynamic walking weight shifting stability indices in amputees was verified. This study provided evidence that sensory feedback neuromuscular stimulation may put amputees at better balance capability.