Understanding Muscle Loading Strategies and Stress on the Lower Back During Daily Activities in Individuals with Traumatic Lower Limb Amputation: A Systematic Review
Journal of Prosthetics and Orthotics, 2026 (ESCI, Scopus)
- Yayın Türü: Makale / Tam Makale
- Basım Tarihi: 2026
- Doi Numarası: 10.1097/jpo.0000000000000641
- Dergi Adı: Journal of Prosthetics and Orthotics
- Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, CINAHL, SportDiscus, Academic Search Ultimate (EBSCO)
- Anahtar Kelimeler: activities of daily living, low back pain, lower limb amputation, lumbar loads, motion analysis
- Hacettepe Üniversitesi Adresli: Evet
Özet
Objective: – Low back pain affects over half of individuals with lower limb amputations and can significantly interfere with daily activities. Asymmetric gait patterns and compensatory postural strategies adopted after amputation may contribute to increased stress on the lumbar spine. This review investigates muscle forces and biomechanical stressors acting on the lumbar region during activities of daily living in individuals with traumatic lower limb amputations. Methods: – PubMed, Scopus, and Web of Science databases were systematically searched for relevant observational studies, according to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The included studies were evaluated for quality, risk of bias, and evidence level. They were rated using the Downs and Black Quality Assessment Tool and the Cochrane Back Review Group rating scale. The study protocol was registered in the PROSPERO database. Results: – Estimated lumbar loads exhibited asymmetry during functional activities in individuals with traumatic lower limb amputation, particularly in the anterior-posterior and medial-lateral directions. Additionally, modeled local and global muscle forces around the lower back demonstrated an imbalance, with compensatory activation patterns observed across different muscle groups. Conclusion: – Repetitive asymmetric loading and altered muscle activation patterns may be associated with potential risks to lumbar health in individuals with lower limb amputations. Clinical Relevance: – This review emphasizes the common occurrence of compensatory movements, even among the young and active amputee population. Various rehabilitative approaches may serve as preventive strategies. (J Prosthet Orthot. 2026;X:XX–XX)