Dynamic and Static Postural Control in Volleyball Players with Transfemoral Amputation

ABSTRACT Introduction: A decrease in postural control and proprioception is a common result of lower limb amputation. However, postural control adaptation in Paralympic sitting volleyball players with lower limb amputation is not yet understood. Objective: The purpose of this cross-sectional controlled study was to investigate static and dynamic postural control in sitting volleyball players with unilateral transfemoral amputation. Methods: Sixteen subjects participated in the study, eight of whom were amputees with unilateral transfemoral amputation (amputee group: age: 33.5 ± 5.6 years, weight: 77.7 ± 5.3 kg, height: 179.4 ± 5.3 cm) and eight physically active non-amputees (control group age: 27.2 ± 8.4 years, weight: 82.7 ± 6.6 kg, height: 178.7 ± 6.1 cm). Static and dynamic postural control was evaluated using the Neurocom® Balance Master System platform (Modified Clinical Test of Sensory Interaction on Balance, Limits of Stability, Rhythmic Weight Shift, Sit-to-Stand, Walk Across, and Step and Quick Turn). Statistical analyses were performed with the Shapiro-Wilk test, Levene's test, and Student's t-test for paired samples (p <0.05). Results: The amputee group demonstrated impaired postural control in all tests when compared to the control group (p .05). Conclusion: Despite training in sitting volleyball, our results demonstrated that amputees have poorer postural control in both static and dynamic tasks when compared to physically active non-amputees. Level of Evidence II; Prognostic Studies—Investigating the Effect of a Patient Characteristic on Disease Outcome / Retrospectivef Study.

摘要
引言：下肢截肢术后常出现姿势控制与本体感觉功能减退，但目前针对下肢截肢的残奥会坐式排球运动员的姿势控制适应机制仍不明确。
目的：本项横断面对照研究旨在探讨单侧经股截肢坐式排球运动员的静态与动态姿势控制能力。
方法：本研究共纳入16名受试者，其中8名为单侧经股截肢运动员（截肢组：年龄33.5±5.6岁，体重77.7±5.3kg，身高179.4±5.3cm），另8名为身体活动水平匹配的非截肢者（对照组：年龄27.2±8.4岁，体重82.7±6.6kg，身高178.7±6.1cm）。采用Neurocom®平衡主系统（Neurocom® Balance Master System）平台开展姿势控制评估，测试项目包括改良版平衡感觉交互临床测试（Modified Clinical Test of Sensory Interaction on Balance）、稳定性极限测试（Limits of Stability）、节律性体重转移测试（Rhythmic Weight Shift）、坐站转换测试（Sit-to-Stand）、跨走测试（Walk Across）以及跨步与快速转向测试（Step and Quick Turn），以此评估静态与动态姿势控制能力。统计分析采用夏皮罗-威尔克（Shapiro-Wilk）检验、莱文（Levene）检验以及配对样本学生t（Student's t）检验，检验水准设定为p<0.05。
结果：与对照组相比，截肢组在所有测试项目中均表现出姿势控制能力受损（p<0.05）。
结论：尽管接受坐式排球专项训练，本研究结果显示，与身体活动水平匹配的非截肢者相比，单侧经股截肢运动员在静态与动态姿势任务中的姿势控制能力均更差。
证据等级II；预后研究——探讨患者特征对疾病结局的影响 / 回顾性研究。