Abdullah Alhuzaymi, Goeran Fiedler

EXPLORING THE CORRELATION BETWEEN GAIT SPEED AND BALANCE IN LIMB PROSTHESIS USERS: A PILOT STUDY

Introduction

Exploring the correlation between gait speed and balance in limb prosthesis users: a pilot study. Pilot study explores the correlation between gait speed and balance in limb prosthesis users. Findings suggest faster walking often links to better balance, informing tailored rehabilitation.

Abstract

BACKGROUND: Increasing balance and stability, along with efficient locomotion, is a high-priority goal of physical rehabilitation after limb loss in order to facilitate effective participation in society. Research in the general population suggests that the ability to walk fast is correlated to good performance in balance tests. However, it is unclear if and how prosthesis use influences this correlation. OBJECTIVE: Our small-sample pilot study aimed to explore whether the general relationship between walking speed and balance holds true for people with limb loss whose physical capabilities are inevitably influenced by their prosthetic devices. METHODOLOGY: Participants with any level of limb loss were recruited and asked to perform the Ten-Meter Walk Test and Narrowing Beam Walking Test. Scores in both tests were analyzed using Spearman’s rank correlation coefficient. FINDINGS: The initial sample of eleven participants was reduced to eight (5 males, 3 females, mean age 52 years, mean height 171 cm, mean weight 68 kg, mean BMI 23, limb loss levels ranging from partial hand to trans-femoral amputation) after removing outliers. The mean Ten-Meter Walking velocity was 1.16 m/s, and the mean Narrowing Beam Test score was 11.38. The results indicate a medium to strong correlation between fast walking speed and high balance scores (ρ = 0.681, p = 0.063) when outliers are excluded. CONCLUSION: These findings are consistent with prior research conducted in other populations. However, outliers in our data suggest that this relationship is not universal across all individuals with limb loss. Possible confounding variables include the activity level and the respectively prescribed prosthetic technology. Our finding, that gait speed and balance scores should be evaluated separately to tailor rehabilitation strategies effectively, is preliminary and needs to be confirmed in a larger study. Layman's Abstract Losing a limb can have a major impact on a person’s daily life, including their ability to stay active, feel confident, and avoid accidents like falling. One of the main goals of physical rehabilitation after limb loss is to help people regain balance and stability, so they can move around safely and take part in everyday activities. We know from research on the general population that people who walk faster also tend to have better balance. But it is unclear if this same connection applies to people who use prosthetic limbs, since their walking ability is affected by both their physical condition and the type of prosthesis they use. This pilot study explored how walking speed relates to balance in eleven people with limb loss (8 men, 3 women), of whom three were eventually excluded from the final analysis. Participants completed two tests: a 10-meter walk to measure speed and a narrowing beam test to assess balance. We found that faster walkers generally had better balance scores, with some exceptions that might be due to the challenges of using prostheses. These early findings suggest that both walking speed and balance should be considered separately when designing prosthetic care to improve stability and reduce fall risk. Larger studies are needed to confirm these results, as this was a small feasibility study to test procedures and gather initial data. Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/45517/34223 How To Cite: Alhuzaymi A, Fiedler G. Exploring the correlation between gait speed and balance in limb prosthesis users: A pilot study. Canadian Prosthetics & Orthotics Journal. 2025; Volume 8, Issue 1, No. 8. DOI:10.33137/cpoj.v8i1.45517 Corresponding Author: Goeran Fiedler, PhDAffiliation: Department of Rehabilitation Science and Technology, University of Pittsburgh, USA.E-Mail: gfiedler@pitt.eduORCID ID: https://orcid.org/0000-0003-1532-1248

Review

This pilot study admirably addresses a critical gap in the literature concerning the intricate relationship between gait speed and balance in individuals using limb prostheses. Building upon established correlations within the general population, the authors sought to determine if this relationship holds true for a population whose mobility is inherently influenced by prosthetic technology. Using standardized assessments like the Ten-Meter Walk Test and the Narrowing Beam Walking Test, the study identifies a medium to strong correlation (ρ = 0.681, p = 0.063) between faster walking speed and superior balance scores among the included participants. This preliminary finding, consistent with research in other demographics, provides valuable foundational insights into rehabilitation strategies for prosthesis users, suggesting a potential link that warrants further investigation. While the study presents compelling initial data, its pilot nature inherently comes with limitations that necessitate cautious interpretation. The most significant constraint is the extremely small sample size of eight participants following outlier exclusion, which impacts the statistical power and generalizability of the findings. The heterogeneity of limb loss levels, ranging from partial hand to trans-femoral amputation, while offering broad insight for a pilot, likely introduces variability that could obscure more specific relationships. Furthermore, the discussion of outliers, and their exclusion from the main correlation analysis, highlights the complexity of this population and the potential influence of uncontrolled confounding variables such as activity level and specific prosthetic technology, which were acknowledged but not measured or controlled for in this preliminary work. Despite these limitations, the study successfully lays the groundwork for future research. The authors' conclusion, that gait speed and balance may need separate evaluation for effective rehabilitation strategies, is a significant practical implication, even if preliminary. Future studies should prioritize a larger, more diverse yet potentially stratified sample to confirm these findings and explore the nuances across different amputation levels and prosthetic devices. Incorporating measures of activity level, type of prosthesis, and time since amputation could help elucidate the confounding variables identified. Ultimately, this pilot study serves as an important first step, emphasizing the need for tailored interventions in prosthetic rehabilitation to optimize stability and reduce fall risk, and provides a clear direction for more robust, comprehensive research in this understudied area.

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