Ulus Travma Acil Cerrahi Derg. 2025; 31(3): 259-268 | DOI: 10.14744/tjtes.2024.83923

Comparison of trauma and diabetes mellitus-induced transtibial amputees in terms of gait parameters and functional capacity

Neþe Tosun¹, Fatih Erbahçeci^2
1Department of Therapy and Rehabilitation, Gaziantep University, Gaziantep-Türkiye
²Department of Musculoskeletal Physiotherapy and Rehabilitation, Hacettepe University Faculty of Physical Therapy and Rehabilitation, Ankara-Türkiye

BACKGROUND: The aim of this study was to compare gait parameters, balance, weight-bearing symmetry, functional capacity, functional mobility, prosthesis satisfaction, and quality of life between individuals with diabetes mellitus-induced and traumatic transtibial amputations (TTAs).
METHODS: Ten individuals with traumatic transtibial amputation and 10 individuals with diabetes mellitus-induced transtibial amputation were included in the study. All participants in both the trauma and diabetes groups used a vacuum-assisted suction suspension system (VASS) and a carbon composite foot transtibial prosthesis. Gait analysis and weight-bearing symmetry were assessed using a computerized gait analysis system. Balance was evaluated with the Biodex Balance System (BBS), functional capacity with the Six-Minute Walk Test (6MWT), functional mobility with the Timed Up and Go Test (TUG) and the Stair Climbing Test (SCT), prosthesis satisfaction with the Trinity Amputation and Prosthesis Experience Scale (TAPES), and quality of life with the Short Form-36 (SF-36).
RESULTS: When comparing the traumatic and diabetic groups, significant differences favoring the trauma group were found in the following parameters: stride length (SL) (p=0.004), amputated limb step length (ASL) (p=0.019), non-affected limb step length (NSL) (p=0.005), balance assessment parameters of general postural stability (p=0.000), anteroposterior (A-P) postural stability (p=0.000), mediolateral (M-L) postural stability (p=0.007), SCT performance (p=0.000), and the activity restriction subsection of TAPES (p=0.029). No significant differences were observed in gait velocity, cadence, step width, weight-bearing percentage of the amputated and non-affected limbs, TUG performance, SF-36 scores, or the psychosocial adjustment, prosthesis satisfaction, and daily use time subsections of the TAPES.
CONCLUSION: In this study, the use of a VASS prosthesis in both traumatic and diabetic amputees had a positive effect on out-comes in the diabetic group, resulting in comparable results to those of the traumatic group. The fact that diabetic amputees used their prostheses as frequently as traumatic amputees, remained active, and benefited from the choice of prosthesis and suspension system provides valuable insights for healthcare professionals as a facilitating factor in rehabilitation.

Keywords: Amputee, diabetes mellitus, trauma, transtibial, gait.

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Yürüyüþ parametreleri ve fonksiyonel kapasite açýsýndan travma ve diabetes mellitus nedenli transtibial amputelerin karþýlaþtýrýlmasý

Neþe Tosun¹, Fatih Erbahçeci^2
1Terapi ve Rehabilitasyon Bölümü, Gaziantep Üniversitesi, Gaziantep-Türkiye
²Kas Ýskelet Fizyoterapisi ve Rehabilitasyon Anabilim Dalý, Hacettepe Üniversitesi Fizik Tedavi ve Rehabilitasyon Fakültesi, Ankara-Türkiye

AMAÇ: Bu çalýþmanýn amacý diyabetik ve travmatik transtibial amputelerin (TTA) yürüyüþ parametreleri, denge, aðýrlýk aktarma simetrisi, fonksiyonel kapasite, fonksiyonel mobilite, protez memnuniyeti ve yaþam kalitesi sonuçlarýný karþýlaþtýrmak.
GEREÇ VE YÖNTEM: 10 travma 10 diyabet nedenli TTA birey çalýþmaya dahil edildi. Travma ve diyabet gruplarýnda yer alan amputelerin tamamý aktif vakum sistem (AVS), karbon kompozit ayaklý transtibial protez kullanmaktaydý. Yürüyüþ analizi ve aðýrlýk aktarma simetrisi bilgisayarlý yürüyüþ analizi sistemi, denge Biodex Denge Sistemi (BBS), fonksiyonel kapasite Altý Dakika Yürüme Testi (6MWT), fonksiyonel mobilite Zamanlý Kalk Yürü Testi (TUG) ve Merdiven Çýkma Testi (SCT), protez memnuniyeti Trinity Amputasyon ve Protez Deneyim Ölçeði (TAPES) ve yaþam kalitesi Kýsa Form-36 (SF-36) ile deðerlendirildi.
BULGULAR: Travmatik ve diyabetik grup sonuçlarý karþýlaþtýrýldýðýnda yürüyüþ parametrelerinden çift adým uzunluðu (ÇAU) (p=.004), ampute ekstremite adým uzunluðu (AAU) (p=.019), saðlam ekstremite adým uzunluðu (SAU) (p=.005), denge deðerlendirmesinin parametreleri olan genel postural stabilite (p=.000), anterio-posterior (A-P) postural stabilite (p=.000), medio-lateral (M-L) postural stabilite (p=.007), SCT (p=.000), TAPES’in aktivite kýsýtlanmasý alt bölümü (p=.029) parametreleri arasýnda travmatik grup lehine anlamlý fark bulundu. Hýz, kadans, adým geniþliði, ampute ve saðlam ekstremite aðýrlýk taþýma yüzdeleri, TUG, SF-36 ve TAPES (Psiko-sosyal Uyum, Protez Memnuniyeti, Günlük Kullaným Süresi alt bölümleri) parametreleri arasýnda anlamlý fark bulunmadý.
SONUÇ: Çalýþmamýzda travmatik ve diyabetik amputelerin aktif vakum sistem protez kullanmalarý özellikle diyabetik amputelerin sonuçlarýna olumlu yansýmýþ, travmatik amputelerle yakýn sonuçlarýn ortaya çýkmasýna katký saðlamýþtýr. Diyabetik amputelerin protezlerini travmatik amputeler kadar uzun süre kullanmalarý, aktif olmalarý, protez ve suspansiyon sistem seçimi rehabilitasyonu kolaylaþtýrýcý faktör olarak ilgili saðlýk profesyonellerine farklý bir bakýþ açýsý saðlayabilir.

Anahtar Kelimeler: Ampute, denge, diabetes mellitus transtibial travma, yürüyüþ.

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