Reactive Balance Responses in Individuals With Lower Limb Amputation: A Scoping Review
Year: 2026
Type: preprint
Study design: Systematic Review
Abstract: Background: Individuals with lower limb amputation (LLA) have high fall rates, yet balance responses following perturbations remain poorly understood. Improving the understanding of how individuals with LLA react to unexpected balance disturbances may inform prosthetic design and rehabilitation strategies aimed at reducing fall risk. Research question: This scoping review synthesized literature on reactive balance responses following discrete, externally induced perturbations in individuals with LLA. Methods: A systematic search of four databases was conducted in January 2025 for studies comparing responses to discrete, unexpected external perturbations applied during standing or walking in individuals with and without LLA. Data on perturbation characteristics, outcome measures, and between-group differences were extracted and synthesized descriptively. Results: Sixteen studies were included, with half examining perturbations during standing and half during walking. Across studies, 175 individuals with LLA were assessed. Most participants were males (79.8%), had transtibial amputation (94%), and traumatic etiology (72.9%). Perturbations applied during standing were mostly to the base of support in the anteroposterior direction. In contrast, perturbations during walking were applied in a variety of ways and mixed between mediolateral and anteroposterior directions. Outcomes included recovery strategies, response latency, and joint kinematics and kinetics. Substantial heterogeneity in participant characteristics, perturbations paradigms, and outcome measures limited synthesis of reactive balance differences between groups. Significance: The literature reveals key gaps, including limited investigation of step-eliciting and slip-like perturbations, mediolateral balance recovery during standing, and the influence of amputation level, etiology, and fall history. Addressing these gaps is important to fully understand reactive balance in LLA and guide future clinical research.
Source: SSRN Electronic Journal
DOI: 10.2139/ssrn.6555561
Language: English
Field: Health Professions
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7171680400