Award Date

5-15-2026

Degree Type

Doctoral Project

Degree Name

Doctor of Physical Therapy (DPT)

Department

Physical Therapy

First Committee Member

Jenny Kent

Second Committee Member

Daniel Young

Third Committee Member

Kai-Yu Ho

Number of Pages

46

Abstract

Individuals with lower limb amputation (LLA) face an increased risk for falls which may limit mobility, confidence, and participation in daily activities. Current rehabilitation programs for this population rarely integrate surface training as an intervention, despite walking on different surfaces being a necessity to participate in the real world. This feasibility study aimed to evaluate the practicality, acceptability, and preliminary efficacy of an uneven treadmill training protocol for individuals with LLA. Five adults with LLA (P1: transfemoral, 38 years old, 1.75 m, 88.8 kg; P2: hip disarticulation, 38 years old, 1.60 m, 106.7 kg; P3: transfemoral, 53 years old, 1.81 m, 102.8 kg; P4: transtibial, 48 years old, 1.81 m, 93.9 kg; P5: transtibial, 32 years old, 1.83 m, 76.6 kg) participated in a planned 12 session, four-week intervention comprising up to twelve bouts of walking, with a baseline assessment at the beginning and follow-up assessment at the end of the study. Sessions were conducted on a modified treadmill featuring an uneven surface with contour heights ranging from 0-40 mm. Patient-reported outcome measures used were the Activities-specific Balance Confidence Scale (ABC), and Prosthetic Limb Users Survey of Mobility (PLUS-M). Functional outcome measures included the L-test, and Single Leg Balance Test. Adherence to the 12 sessions was high among all participants; however, the number of bouts completed per session ranged from 1 to the maximum of 12. Per collected participant feedback, the participants reported that the treadmill challenged their balance, that they were confident in completing the training, and that they wanted to come to training sessions. Only Participant 5 exceeded the minimal detectable change (MDC) for their prosthetic limb for the Single Leg Balance Test. No other MDC was exceeded on functional and patient-reported outcome measures from pre to post intervention. This uneven terrain treadmill protocol is feasible for individuals with LLA. Future larger scale studies are warranted to determine the efficacy of the use of an uneven treadmill in rehabilitation programs for individuals with LLA.

Keywords

Lower limb amputation; prosthetic rehabilitation; uneven terrain training; treadmill training; gait training; balance confidence; feasibility study; gait

Disciplines

Orthotics and Prosthetics | Physical Therapy

File Format

PDF

File Size

614 KB

Degree Grantor

University of Nevada, Las Vegas

Language

English

Rights

IN COPYRIGHT. For more information about this rights statement, please visit http://rightsstatements.org/vocab/InC/1.0/

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