Balance control deficits in individuals with a transtibial amputation with and without visual input (Moisan et al., 2022)

Prosthetics Education Spotlight

Interviewee: Katia Turcot, Ph.D., Associate Professor, Faculty of Medicine, Department of Kinesiology, Université Laval
Article: Balance control deficits in individuals with a transtibial amputation with and without visual input
Gabriel Moisan, Ludovic Miramand, Hanneh Younesian, Katia Turcot
Université Laval, Faculty of Medicine, Department of Kinesiology
Centre for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS)

Key Takeaways

  • Amputees displayed an asymmetrical loading pattern during quiet standing tasks with greater loads on their sound side compared to their affected side
  • Visual input is critical for maintaining balance in transtibial amputees
  • When vision was deprived, balance was significantly affected in amputees compared to when vision was normal

Please tell us about your lab, your team, and your research interests
Our team is interested in the lower limb amputee population, and we have many objectives we wish to accomplish with our research. Firstly, we would like to better understand the body motion strategy developed by lower limb amputees to help them maintain their functional level during activities of daily living and also understand any coping strategies that they may have for pain they may experience in adjacent joints. Secondly, the team would like to develop new biomechanical indicators that can help improve follow-up with clinicians. An example of the applicability of this research would be to help improve the way a prosthesis is prescribed or adjusted at an appointment. Lastly, we would like to research ways to prevent the development of secondary joint diseases in the lower limb amputee population, such as osteoarthritis or back pain.

What are you working on right now that you are most excited about?
We are currently working on many projects. One of the goals of our research is for it to be
transferrable from the lab to more ecological settings in which an amputee may find themselves. For example, one of our projects is studying the joint distribution during functional tasks, such as a sit to stand and exploring what the impact of different devices is on the task and if the joint moments change throughout the task. Another project is examining how amputees navigate stairs, and the impact of aids, such as ramps, how they are being used, and what strategies are being used to navigate these environments, and how these strategies can help prevent the development of secondary pathologies.
In addition to research done exclusively within our lab, we also work in collaboration with
industry partners. We are currently working with Ethnocare, a Quebec-based start-up, to help validate their technology. They have developed a thin sleeve worn over a prosthetic liner that has an integrated adjustment system to help control volume changes in the residual limb throughout the day. This is accomplished through a series of pneumatic cells embedded in the sleeve, and the objective of the sleeve is to replace the need for prosthetic socks. Finally, the project that we are most excited about is another collaborative project where we are hoping to provide all lower limb amputees with access to the motion lab as we believe that this will help clinicians better adjust and align prostheses. Right now, we are in the process of obtaining funding to make this a reality so that clinicians can access the lab when working with their clients.

What are next steps based on your research? How can we integrate your findings into
clinical practice?

Our main goal is to develop biomechanical indicators that clinicians can use in their daily practice when working with clients. With these biomechanical indicators we hope to provide more objectivity to tests clinicians may conduct with their clients. We are working with our system and more portable systems, such as inertial sensors, simultaneously, and the goal is to instrument the tests to help better quantify the outcomes. For example, in a 6 minute walk test the sensors can provide information regarding how gait changes over the duration of the test, biomechanical differences between transtibial and transfemoral amputees, or if spatiotemporal parameters degrade over the test. All of our research is very collaborative, and we involve many other healthcare professional including physiatrists, physiotherapists, and prosthetists.

Create a website or blog at