IJOT : Vol. XLI : No. 3 September 2009 - December 2009 63 EFFECT OF BALANCE EXERCISE ON BALANCE CONTROL IN UNILATERAL LOWER LIMB AMPUTEES * Damayanti Sethy, M. O.T., Co-Authors : ** Eva Snehlata Kujur, M.O.T.; *** Kaushik Sau, M.O.T. Abstract : OBJECTIVES- 1. To study the effect of balance exercise on balance control of unilateral lower limb amputees. 2. To study the difference in balance control in Trans Femoral and Trans Tibial amputees. METHODOLOGY-Thirty unilateral Trans-femoral and Trans-tibial amputees were selected and divided into two groups of 15 each. Control group received conventional training and Experimental group received conventional training along with Phyaction balance exercise. Duration of treatment was 30 minutes, five days a week for four weeks. Pre and Post training evaluation of functional reach, and Global balance performance was done for both the groups. Statistical analysis was done by t test. RESULT: Statistically significant improvement was seen in all the outcome measures in experimental group and no significant improvement was seen in case of control group which shows that balance exercise is effective in controlling balance in unilateral lower limb amputees. CONCLUSION: Early phase balance exercise is effective in controlling balance of unilateral lower limb amputees. Area covered by the non-affected limb was more in comparison to the prosthetic limb, so strengthening of the non-affected limb should be incorporated in the rehabilitation of unilateral lower limb amputees. Keywords: Balance training, Amputees, perturbation, Prosthesis. INTRODUCTION: Postural stability is essential to the performance of most daily activities and is necessary to lead an independent life. Gait and balance impairments may increase the risk of falls, the leading cause of accidental death. Fall related injuries constitute a serious public health problem associated with high costs for society as well as human suffering 1 . In able-bodied individuals the ankle joint and leg musculature play an important role in maintaining balance by appropriately shifting the center of pressure 2 . The reorganization of standing balance after a lower limb amputation is considered, with emphasis on persons with an acquired unilateral amputation above the ankle and below the hip joint. In the first section, three major peripheral motor The Indian Journal of Occupational Therapy : Vol. XLI : No. 3 (September 2009 - December 2009) * Occupational Therapist ** Sr. Occupational Therapist *** Jr. Lecturer Place of Study : National Institute for the Orthopaedically Handicapped, Kolkata Period of Study : August 2007 - December 2008 Correspondence : Dr. Damayanti Sethy Occupational Therapist, National Institute for the Orthopaedically Handicapped, B.T. Road, Bonhoogly, Kolkata-90, W.B. Tel. : 09831318686 E-mail : damayanti.sethy@gmail.com and sensory impairments are discussed: (a) a lack of ankle torque generation to restore equilibrium in the sagittal plane, (b) a lack of weight-shifting capacity to control posture in the frontal plane and (c) a distorted somato-sensory input from the side of amputation 3 . Falling is an important clinical problem in amputee population. Balance confidence was the only factor associated with mobility capability and performance and social activity. 4 Miller WC et al 2001 5 in their study with 435 unilateral below knee and above knee lower limb amputees found that exactly 52.4% subjects reported falling in the past year, whereas 49.2% reported a fear of falling and concluded that Falling and fear of falling are pervasive among amputees. Hof AL et al (2007) 6 studied control of lateral balance in walking of Trans femoral amputees and their study found that amputees showed asymmetric gait with shorter stance (60%) at the prosthetic side versus 68% at the non-prosthetic side. Backley JG et al (2002) 7 studied balance performance of lower limb amputees during quiet standing and under dynamic conditions. They used a single axis stabilimeter to assess the center of pressure (COP) excursions in both the situations and found that Amputees had a greater problem controlling dynamic balance in the antero -posterior direction than medio- lateral direction. PDF created with pdfFactory trial version www.pdffactory.com