Companies are becoming increasingly aware of the health of their employees and are now integrating exoskeleton solutions for both prevention and job maintenance. However, the effect of using exoskeletons is still an open question. Therefore, this study aimed to evaluate the impact of an active lumbar exoskeleton and its passive belt on trunk kinematics and muscle activity using instrumented motion analysis. Twenty-three healthy subjects volunteered to perform three handlings of a 5 kg load (free lifting, squat lifting, and load transfer) under three different experimental conditions. The “Control” condition was when the subject did not wear any device, the “Belt” condition was when the subject wore only the passive part of the exoskeleton, and the “Exo” condition was when the subject wore the active exoskeleton. Based on the Rapid Upper Limb Assessment scale, the exoskeleton reduced the time spent in angles that were considered dangerous for the back, according to ergonomic evaluations. Furthermore, for the handling sessions, it was observed that the exoskeleton did not modify muscle activity in the abdominal–lumbar region.

Introduction Lower extremity amputations (LEA) impact the quality of life and physical abilities and increase the risk of developing secondary complications. While most research focuses on major LEA, minor LEA remain understudied despite their rising incidence. These amputations alter the sensorial and mechanical properties of the foot, affecting postural control and stability. Understanding these biomechanical changes is essential for improving rehabilitation strategies. Objectives The scoping review will synthesize current research on postural control deficits following a minor LEA, focusing on any resections through or distal to the ankle joint. It will also evaluate whether interventions, such as orthotic devices and balance rehabilitation programs, have been investigated to mitigate balance impairments in this population. Inclusion criteria The scoping review will include studies on individuals with a minor LEA, across various age, levels, and etiologies. The scoping review will focus on quantitative data related to standing balance and postural control, dynamic functional tests, and self-reported questionnaires on balance capacity and confidence. Studies assessing interventions for postural control restoration will be analyzed separately as a secondary outcome. Methods A preliminary search of MEDLINE (PubMed) was conducted to develop a full search strategy aimed at compiling all existing scientific articles on postural control and balance in individuals with a minor LEA. The subsequent comprehensive search will be performed across multiple databases and grey literature. Two independent reviewers will independently extract the data. The Joanna Briggs Institute Quality Assessment Tool will be used to assess risk of bias and quality of included studies. Discussion By mapping the literature on postural control in individuals with a minor LEA, the scoping review will highlight knowledge gaps and provide guidelines for future biomechanical and postural research protocols. It will also assess the current state of therapeutic intervention research as a secondary outcome, providing insights for clinical rehabilitation strategies.

Introduction Lower extremity amputations (LEA) impact the quality of life and physical abilities and increase the risk of developing secondary health complications. Current literature predominantly focuses on major LEA, leaving a gap in understanding biomechanics related to balance and postural control in minor LEA. The shifts towards increased rates of minor LEA, due to improved quality of care and patient management, highlights the need for a focused exploration of postural control deficits in this population. The scoping review will address this gap in the literature. Objectives The purpose of the review is to synthesize current research on postural control deficits following a minor foot amputation, focusing on any resections through or distal to the ankle joint, and to evaluate interventions aimed at improving balance in affected individuals. Inclusion criteria The review will encompass individuals of all ages who underwent a minor foot amputation, including various levels and etiologies. It will focus on quantitative data related to standing posture, ability to perform self-balanced activities of daily living, and external aids or treatments to improve postural control. The outcomes will include modifications in the sensation of balance, fall predictors, and biomechanical changes in postural control. Methods A preliminary search of MEDLINE (PubMed) was conducted to develop a full search strategy aimed at compiling all existing scientific articles on postural control and balance in individuals with a minor LEA. A comprehensive search will be performed across multiple databases and grey literature. Two reviewers will independently extract the data. The Mixed Methods Appraisal Tool will be used to assess risk and quality. Discussion By emphasizing the understudied aspects of postural control imbalances induced by minor LEA, the review will highlight potential areas for therapeutic intervention and contribute to a better understanding of rehabilitation for those affected.

Minor lower extremity amputations (LEA) compromise postural control and increase the risk of falls. This issue is exacerbated by conditions such as diabetes, which affect proprioception and sensorimotor mechanisms. While orthopedic devices, including prostheses and orthoses, are frequently prescribed, their specific role in restoring postural control remains underexplored. This scoping review aimed to synthesize current research on postural control in individuals with a minor LEA and to evaluate the interventions that may improve balance. A systematic search was conducted across databases (MEDLINE, CINAHL, SPORTDiscus, Cochrane) and grey literature, targeting studies employing biomechanics (e.g., kinetics, kinematics), functional tests (e.g., Functional Reach Test, Timed Up and Go) and self-reported assessments of balance confidence, fall risk, and physical performance. Fifteen articles involving 288 individuals with various levels of minor LEA were included. Increased risk of falling were evidenced by lower scores on functional balance tests, with postural deficits confirmed by biomechanical measurements in both static and dynamic conditions. Custom orthotic devices improved functional performance and biomechanical outcomes, suggesting their effectiveness in restoring balance. Prosthetic devices, such as custom prosthetic shoes, enhanced postural stability and facilitated smoother weight transitions during tasks. However, small sample sizes and inconsistent evaluation protocols, complicate understanding of their effectiveness in rehabilitation. This scoping review highlights the underestimated postural challenges experienced by individuals with a minor LEA and supports the role of orthotic and prosthetic interventions in restoring balance. High-quality research to guide clinical decision-making in this population is needed.

Restoring independent daily activity is crucial for patients with a lower extremity amputation. Amputations at or distal to the midtarsal level pose unique challenges, necessitating specialized prosthetic and orthotic interventions to improve functionality, wellness, and quality of life. The objective of this scoping review was to examine the impact of prosthetic and orthotic use on clinical and health care outcomes in adults with a minor lower extremity amputation. Following Arksey and O'Malley's framework and the updated Joanna Briggs Institute's methodology, a systematic search of MEDLINE, CINAHL, SPORTDiscus, APA PsycInfo, Scopus, and the Cochrane Database of Systematic Reviews, was conducted. Fifty-nine relevant studies, primarily originating from the United States of America and Australia, were included. Trauma (47.5%) and diabetes (35.6%) were the leading causes of amputation. The most reported biomechanical outcomes were gait alterations (49.2%), revealing deficits and improvements in spatiotemporal parameters (33.9%), and plantar pressure distribution (22.0%). Custom-made devices insertable into the shoe, such as toe fillers and foot orthoses, enhanced walking speed and plantar pressure distribution, whereas above-ankle devices were more effective than foot orthoses in more proximal amputations. Well-fitted devices increased satisfaction and quality of life, but economic impacts were less frequently addressed. Despite most of the included studies being case reports (23.7%), which have a higher risk of bias, the review underscores the essential role of prosthetic and orthotic prescriptions based on tailored patient-centered care. The findings highlight the need for higher-quality research considering cost, and a broader range of patient-related outcomes and experiences measures, including psycho-social aspects.