Çelik Hüseyin, Türkmen Mustafa Cem, Yalçın Ali İmran, Topuz Semra
Deparment of Therapy and Rehabilitation, Physiotherapy Program, Sungurlu Vocational School, Hitit University, Corum, Turkey.
Deparment of Therapy and Rehabilitation, Disabled Care and Rehabilitation Program, Sabuncuoglu Serefeddin Health Services Vocational School, Amasya University, Amasya, Turkey.
PLoS One. 2025 Sep 26;20(9):e0333213. doi: 10.1371/journal.pone.0333213. eCollection 2025.
Transtibial amputation affects postural stability, requiring trunk muscle analysis to support balance and rehabilitation. This pilot study aimed to compare trunk muscle activations during postural sway and limits of stability in unilateral transtibial amputees with healthy controls and investigate the relationship between postural control and trunk muscle activations in transtibial amputees. Accordingly, it was hypothesised that transtibial amputees would exhibit altered postural control and trunk muscle activation, both compared to controls and between limbs. This preliminary observational cross-sectional study included a transtibial amputee group (n = 10) and a healthy control group (n = 10). Static and dynamic balance were assessed using a Bertec force platform. Trunk muscle activation was measured bilaterally using the Delsys wireless surface electromyography system while balance was assessed. Subsequently, group differences in postural control and trunk muscle activation were analyzed. Transtibial amputee group showed significantly greater limits of stability distance on the amputated side compared to controls' non-dominant side (p < 0.05). Additionally, transtibial amputee group exhibited greater lateral postural sway under compliant surface conditions compared to healthy controls (p < 0.05). During limits of stability assesment, external oblique activation was higher on the intact side of transtibial amputee group compared to controls' dominant side and higher than on the amputated side (p < 0.05). Multifidus activation on the amputated side during compliant surface with eyes open was greater than the intact side (p < 0.05). Longissimus dorsi activation on the intact side in amputee group exceeded controls' dominant side under all conditions (p < 0.05). Moreover, longissimus dorsi activation on the amputated side was significantly higher than on the controls' nondominant side during compliant surface with eyes closed (p < 0.05). Preliminary findings highlight disrupted postural control and trunk muscle activation in transtibial amputees, indicating the need for targeted rehabilitation and larger studies.
经胫截肢会影响姿势稳定性，需要对躯干肌肉进行分析以支持平衡和康复。这项初步研究旨在比较单侧经胫截肢者与健康对照组在姿势摆动和稳定性极限期间的躯干肌肉激活情况，并研究经胫截肢者的姿势控制与躯干肌肉激活之间的关系。因此，研究假设经胫截肢者与对照组相比以及双下肢之间会表现出姿势控制和躯干肌肉激活的改变。这项初步观察性横断面研究包括一个经胫截肢者组（n = 10）和一个健康对照组（n = 10）。使用Bertec测力平台评估静态和动态平衡。在评估平衡时，使用Delsys无线表面肌电图系统双侧测量躯干肌肉激活情况。随后，分析姿势控制和躯干肌肉激活方面的组间差异。与对照组的非优势侧相比，经胫截肢者组在截肢侧的稳定性极限距离显著更大（p < 0.05）。此外，与健康对照组相比，经胫截肢者组在顺应性表面条件下表现出更大的侧向姿势摆动（p < 0.05）。在稳定性极限评估期间，与对照组的优势侧相比，经胫截肢者组健侧的腹外斜肌激活更高，且高于截肢侧（p < 0.05）。睁眼时在顺应性表面上，截肢侧的多裂肌激活大于健侧（p < 0.05）。在所有条件下，截肢者组健侧的背最长肌激活均超过对照组的优势侧（p < 0.05）。此外，在闭眼时顺应性表面上，截肢侧的背最长肌激活显著高于对照组的非优势侧（p < 0.05）。初步研究结果突出了经胫截肢者姿势控制和躯干肌肉激活的紊乱，表明需要进行有针对性的康复治疗和更大规模的研究。
