Standing Requires Increased Cognitive Control for Lower-limb Amputees

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Understanding how people with lower-limb amputations use increased attention in balance and gait to compensate for limb loss can inform prosthetic interventions and training. To that end, researchers at the University of Washington conducted a structured literature review to summarize evidence related to dual-task standing and walking in people with lower-limb amputations. Their review suggested that people with lower-limb amputations use increased cognitive control for standing compared to those without amputations and that microprocessor-controlled knees improve dual-task walking in people with limited mobility compared to non-microprocessor-controlled knees.

A search was completed in PubMed, CINAHL, and Web of Science from each database's inception to May 2017. Eligible articles were in English, included participants with lower-limb amputations, and assessed dual-task standing or walking. Study information was extracted by one reviewer and assessed for accuracy by a second.

Twelve articles met the eligibility criteria. Seven examined differences in dual-task standing or walking, and five assessed dual-task walking across microprocessor-controlled and non-microprocessor-controlled prosthetic knee conditions.

The researchers noted that the small number of studies, diversity of dual-task methods, and methodological limitations challenge the synthesis of study results and suggest that future research should assess specific clinical characteristics that can affect dual-task performance in people with lower limb amputations.