Biofeedback system enhances the time of balance and decreases the duration of pre-prosthetic training?

Silvia Porras-Rangel, Centro de Rehabilitación Integral Sra. Olivia Miramontes Aguirre, Guadalajara, Jalisco, Mexico
Ana B. Aguilar-Valencia, Centro de Rehabilitación Integral Sra. Olivia Miramontes Aguirre, Guadalajara, Jalisco, Mexico
Sandra E. Dau-Iñiguez, Centro de Rehabilitación Integral Sra. Olivia Miramontes Aguirre, Guadalajara, Jalisco, Mexico
Abraham Zepeda-Moreno, Instituto de Cáncer Infantil y de la Adolescencia, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Jalisco, Mexico
Sylvia E. Totsuka-Sutto, Department of Physiology, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Jalisco, Mexico
Iván G. Andrade-Flores, Centro de Rehabilitación Integral Sra. Olivia Miramontes Aguirre, Guadalajara, Jalisco, Mexico
Marisol Agredano-Jiménez, Centro de Rehabilitación Integral Sra. Olivia Miramontes Aguirre, Guadalajara, Jalisco, Mexico
Sergio Sánchez-Enriquez, Biochemical Laboratory, Department of Biologic and Molecular Genomics, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Jalisco, Mexico

Background: Diabetes mellitus is the leading cause of non-traumatic lower limb amputations. The goal of rehabilitation in these patients is to enable them to appropriately handle a prosthesis so they can reintegrate into society. However, many patients do not achieve this goal because they fail to maintain the balance needed to control the prosthesis. Objective: To analyze the effectiveness of a biofeedback electronic system for balance training in patients with femoral amputations secondary to diabetic foot. Methods: A single-blinded, randomized clinical trial was conducted. Forty patients with femoral amputation secondary to diabetic foot were divided into two groups: (i) control (n = 20), with conventional pre-prosthetic training; and (ii) patients rehabilitated with a biofeedback electronic system (n = 20). For each patient, 10, 20, and 30 sessions were carried out and balance measurement (minimum and maximum time of balance) was performed using a digital chronometer at the end of each session. Results: Baseline clinical and demographic characteristics were similar between the two groups. Differences in the minimum time of balance were noted from the 20th session. Patients using biofeedback had a mean minimum time balance of 38.7 ± 41.0 seconds compared to 7.9 ± 3.3 seconds in those who did not (p < 0.01). This difference persisted into the 30th session (57.7 ± 36.8 vs. 16.6 ± 16.1 seconds; p < 0.01). Maximum time balance was also found to be longer in patients from group 1, both at the 20^th (64.5 ± 69.2 vs. 11.2 ± 4.7 seconds; p < 0.01) and the 30^th session (83.9 ± 50.7 vs. 36.4 ± 30.7 seconds; p < 0.01). Conclusions: The electronic balance system is a useful tool for pre-prosthetic training.

Palabras clave: Equilibrium. Balance. Pre-prosthetic training. Social reintegration. Amputee. Diabetes mellitus.