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Effects of Flexible Transfemoral Prostheses on Dynamic Balance in Unilateral Amputees: A Quasi-Experimental Within-Subject Study Rachmat, Nur; Kuncoro, Bambang
Journal of Applied Nursing and Health Vol. 8 No. 1 (2026): Journal of Applied Nursing and Health
Publisher : Chakra Brahmanda Lentera Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55018/janh.v8i1.597

Abstract

Background: Dynamic balance impairment is a major functional challenge in individuals with transfemoral amputation and is closely associated with mobility limitations and increased fall risk. Flexible transfemoral prostheses are widely prescribed to improve ambulation. However, limited biomechanical evidence exists examining how flexible transfemoral prostheses influence dynamic balance performance using standardized functional clinical assessments. This study aimed to examine the effect of flexible transfemoral prosthesis use on dynamic balance in unilateral transfemoral amputees. Methods: This quasi-experimental within-subject study followed the TREND reporting guideline. Thirty unilateral transfemoral amputees were recruited using purposive sampling from the Department of Prosthetics and Orthotics at Poltekkes Kemenkes Surakarta, Indonesia. Inclusion criteria were medical stability and ability to perform multidirectional stepping; exclusion criteria included bilateral amputation and neurological disorders. The independent variable was ambulation condition (axillary crutch ambulation versus flexible transfemoral prosthesis use), and the dependent variable was FSST completion time. Dynamic balance was assessed using the Four Square Step Test (FSST). Analyses were conducted using paired t-tests with 95% confidence intervals. Results: Participants were predominantly male (76.7%) with a mean age of 33.6 ± 9.4 years and a mean post-amputation duration of 4.2 ± 2.1 years. FSST completion time significantly decreased during flexible transfemoral prosthesis use compared with axillary crutch ambulation (mean difference = 8.97 seconds; 95% CI, 7.72–10.22; p < 0.001), demonstrating a very large effect size (Cohen’s d = 2.68). Conclusion: Flexible transfemoral prosthesis use significantly enhances dynamic balance in unilateral transfemoral amputees. Flexible transfemoral prostheses should be considered an essential component of function-oriented rehabilitation strategies to optimize postural control and safe mobility. Future longitudinal and instrumented biomechanical studies are warranted to further elucidate underlying adaptation mechanisms.
DIFFERENCES IN WALKING BALANCE ACROSS BODY MASS INDEX ANDFALL RISK CATEGORIES AMONG OLDER ADULTS Rachmat, Nur; Syafii, M; Septiani, Anissa Eka; Mayang, Tarezza Dewi Sekar; Yulianti, Indra
International Journal of Nursing and Midwifery Science (IJNMS) Vol. 10 No. 1 (2026): VOLUME 10 ISSUE 1 APRIL 2026
Publisher : Departement Research and Community Engagement Bina Sehat PPNI Institute of Health Science, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29082/IJNMS/2026/Vol10/Iss1/807

Abstract

This study aimed to examine differences in walking balance across body mass index (BMI) categories and fall risk categories among community-dwelling older adults. Methods: A cross-sectional study was conducted involving 55 older adults aged 50–90 years in a community setting in Central Java, Indonesia. Body mass index was classified using Asia–Pacific criteria. Fall risk was assessed using the Morse Fall Scale, and walking balance was evaluated using the 8-Foot Up and Go test, categorized as balanced or impaired. Data were analyzed using descriptive statistics and Pearson’s chi-square test. Results: The mean age of participants was 63.16 ± 8.60 years, and the mean BMI was 22.02 ± 3.86 kg/m². Overall, 69.1% of participants exhibited impaired walking balance. No significant association was found between BMI category and walking balance status (χ² = 4.78, p = 0.188). In contrast, fall risk category showed a significant association with walking balance status (χ² = 11.61, p = 0.003), with higher fall risk corresponding to greater balance impairment. Conclusion: Walking balance impairment among older adults was significantly associated with fall risk category but not with BMI classification. These findings indicate that fall risk assessment provides greater clinical relevance for identifying balance impairment than anthropometric measures alone.
Co-Authors Agus Seto Nugroho Ahmad Hisyam Aji Janmo Minulyo Aji, Sherly Ratih Frichesyarius Santi Alfan Zubaidi Alfan Zubaidi ANDYARINI, ESTI NOVI Anik Indah Yani Anik Indah Yani Anissa Eka Septiani Annisa Eka Septiani Atika Febri Anggriani Ayuningtyas, Roro Aji Bambang Kuncoro Bambang Kuncoro Bambang Kuncoro Bambang Kuncoro Bee, Vanness Devi Elvina Rachma Doddy Suprayogi Dodiet Aditya Setyawan Dola Fitritha Raras Handayani Dwi Nurul Izzhati Dwi Setyawan Dwi Setyawan E. Saputra Saputra Esa Ridho Sambada Eviana S. Tambunan Fadhila Firmanurulita Fajar Susanti Faried Effendi Surono Fitri Khoirun Nisa haidar abdurrahman prawira Handayani, Dola Fitritha Raras Hanifah Hanifah Hanna Lestari Herawati Prianggi Herawati Priangi Hidayati, Betty Indra Yulianti Indri Kusuma Dewi, Indri Kusuma Ismi Dwi Syafitri Izha Mahendra Jusuf Kristianto M Syafii Maharani Nadia Andarini Masdeniati, Masdeniati Mayang, Tarezza Dewi Sekar Muhammad Syafii Muhammad Syaifudin Mulyaningrum, Haryanti Katini Nella Tri Surya Ni Made Riasmini Noorma, Nilam Prasetya, Hanung Prasetyo Catur Utomo Prasetyo Catur Utomo Prasetyo Catur Utomo Prianggi, Herawati Putra, Aji Putri Utami Sulistyawati R. Ismail Ismail Rachma, Devi Elvina REZA FAHLEVI Rini Tri Hastuti Rizi, Muhammad Alfa Rustam Aji, Rustam Septiani, Anissa Eka Setyorini, Yuyun Setyorini Siska Meiwijayasmi Sisybania Sri Djuwitaningsih Subagiyo, Didik SULISTIYANI SULISTIYANI Surya, Nella Tri Suryaningsih, Anthik Fajar Syafii, M Tri Handayani Wibowo, Suluh Arif Zenitha Bela Pratiwi Kusumawati