This research has informed British and Dutch national clinical guidelines on the rehabilitation of patients following lower limb amputation (LLA), used by 1550 healthcare practitioners. Through STEPFORWARD, the research has demonstrated the benefits of a functional ankle-foot prothesis, improving patients’ daily function and quality of life in meaningful ways, including reduced pain and enhanced mobility.
The research has also led to the establishment of KEEP MOVING, an innovative community-based exercise programme for patients in and around East Yorkshire and North Lincolnshire and accessible nationally online via the Limbless Association. KEEP MOVING has benefitted the physical and mental health of those with a LLA, positively reducing falls, improving their general fitness, and facilitating a social support group that had been missing locally.
Participants have talked about how the research has helped improve their lives:
“the big thing is it’s a social group of similar people that have got similar sorts of problems...one of the things you find when this happens [amputation] is you can become a bit cut off and isolated...I was depressed... So, I’ve now got a social group that I mix with...I’ve rediscovered some muscles I didn’t think I had before...So I think my all-round level of fitness has improved”
“Well, the best thing about it was I could get up and walk about without being in a lot of pain in the foot... you felt the difference as soon as they put the [self-aligning ankle-] foot on and I stood up and walked. There was just no pressure in the knee, none in the hip and no pain at all...it was a lot better walking. It’s more comfortable. It’s the best thing that could have happened”
Vanicek N, Strike S, McNaughton L, Polman R. Postural responses to dynamic perturbations in amputee fallers vs. non-fallers: a comparative study with able-bodied subjects. Arch Phys Med Rehabil 2009b; 90: 1018-1025. http://dx.doi.org/10.1016/j.apmr.2008.12.024
Vanicek N, Strike S, McNaughton L, Polman R. Gait patterns in transtibial amputee fallers vs. non-fallers: biomechanical differences during level walking. Gait Posture2009a; 29: 415-420. http://dx.doi.org/ 10.1016/j.gaitpost.2008.10.062
Schafer ZA, Perry JL, Vanicek N. A personalised exercise programme for individuals with lower limb amputation reduces falls and improves gait biomechanics: A block randomised controlled trial. Gait Posture 2018; 63: 282-289. https://doi.org/10.1016/j.gaitpost.2018.04.030
Vanicek N. Specialised exercise for individuals with lower limb loss: Reflections from Hull. In International Society for Prosthetics and Orthotics (ISPO UK MS) Annual Scientific Meeting, Southampton, 2018
Mitchell N, Coleman E, Watson J, Bell K, McDaid C, Barnett C, Twiste M, Jepson F, Salawu A, Harrison D, Vanicek N. Self-aligning prosthetic device for older patients with vascular-related amputation: protocol for a randomised feasibility study (the STEPFORWARD study). BMJ Open 2019; 9:e032924 http://dx.doi.org/10.1136/bmjopen-2019-032924
Vanicek N, Coleman E, Watson J, Bell K, McDaid C, Barnett C, Twiste M, Jepson F, Salawu A, Harrison D, Mitchell N. STEPFORWARD study: a randomised controlled feasibility trial of a self-aligning prosthetic ankle-foot for older patients with vascular-related amputations. BMJ Open 2021; http://dx.doi.org/10.1136/bmjopen-2020-045195
Schafer ZA, Vanicek N. A block randomised controlled trial investigating changes in postural control following a personalised 12-week exercise programme for individuals with lower limb amputation. Gait Posture 2021; 84: 198-204 https://doi.org/10.1016/j.gaitpost.2020.12.001