Enhancing Motor Function in Individuals with Lower Limb Amputation Through Peer-Based Balance and Fall Recovery Skill Training
Abstract
Rationale: It is challenging to maintain balance and to arrest accidental falls after leg amputation, even with the best prostheses. The most important goals of post-amputation rehabilitation are to improve safety, reduce fall risk, and improve mobility function. However, despite advancements in prosthetic technology, frequent falls after amputation remain a serious concern for individuals with leg amputation. We believe this is partially due to the current lack of proper scientific knowledge on prosthetic skill learning after amputation. Rehabilitation after amputation involves intense relearning of mobility skills such as walking, weight shifting, and quick stepping to arrest falls. Learning to perform these movements with a prosthesis in place of the lost leg is no easy task. As rehabilitation researchers, we ask the question: How can rehabilitation training after amputation be made more effective? The answer may lie in developing knowledge specifically relevant to improving the learning of prosthetic skills for individuals with leg amputation. Observing and imitating movements performed by others is a common way to learn new skills, including during rehabilitation after leg amputation. Previous studies showed that when observing movements performed by non-amputee actors, individuals with limb loss exhibited atypical brain activation as opposed to when they observed the same actions performed by fellow amputees. In fact, individuals with limb loss often report that the rehabilitation they received often focuses only on basic walking skills, while advanced mobility is self-taught or learnt from other people with similar levels of amputation and other experiences. The relatedness and empathy shared between individuals with similar disabilities can enhance the learning environment and consequently lead to better outcomes. Learning from peers not only provides social support, but may also prime the brain for positive changes. However, this powerful premise has never been explored in the context of amputee rehabilitation. The benefits of peer support for the amputee population are currently only recognized as providing social and psychological support. As a coordinator of an amputee patient support group, I witness firsthand the benefits of peer support in improving not only my amputee members’ psychological well-being but also enabling their physical function. We firmly believe it is important to systematically examine how peer support and peer-based learning may be used to improve rehabilitation outcomes after leg amputation. Objective: The overall goal of this research project is to investigate the effectiveness (Aim 1) and the scientific foundation (Aim 2) of peer-based prosthetic skill training in individuals with leg amputation. Our belief is that amputee learners will show improved skill learning when observing demonstrations from other amputees, as opposed to observing non-amputee models. We will accomplish our objective by executing the following two aims: Aim 1: Determine the effects of peer-based observation training on sensorimotor performance and learning in individuals with LLA. Aim 2: Examine the differences in visual focus, behavioral psychometrics, and brain activation patterns during and after observing motor task demonstrations from amputee peers vs. non-amputees. Who Will This Research Help: Knowledge gained from this research will benefit the active-duty Service Members, Veterans, and civilians with limb loss. This research would be particularly relevant to Service Members who have had amputations as a result of service-related activities, because amputee peer support already exists in a few military care settings for their social and emotional benefits. This research will explore how peer support can be extended to enhance rehabilitation and physical function after amputation. More effective post-amputation rehabilitation may enable injured Warfighters to return to duty and reduce the ri
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Dec 28, 2022
- Source ID
- W81XWH2210216
Entities
People
- Szu-Ping Lee
Organizations
- United States Army
- University of Nevada, Las Vegas