The effects of spinal stabilization exercises on energy expenditure in individuals with transtibial amputation

The aim of this study is to investigate the effect of spinal stabilization exercises applied together with the classical physiotherapy program on the stabilization strength of deep spinal muscles, energy expenditure, exercise capacity, fatigue, functional mobility and perceived mobility level with the prosthesis in individuals with unilateral transtibial amputation. Eighteen individuals with transtibial amputation with a mean age of 38.61±9.11 years were included in the study. Individuals were divided into two groups as group 1 and group 2 randomly. Classical physiotherapy program was applied to individuals in Group 1 for 8 weeks, and spinal stabilization exercise training was applied to individuals in Group 2 together with classical physiotherapy program. At the beginning and end of exercise training; Maximal energy expenditure (kcal/h) and exercise capacity (mL/kg/min) were evaluated during the "6 Minute Stepper Test" (6DST) using a portable exercise tester. Fatigue assessment was done before and after 6DST with the "Modified Borg Scale". The stabilization strength of the deep spinal muscles (mmHg) was evaluated with the "Pressure Biofeedback Unit". Functional mobility was evaluated with the "Timed Up and Go Test" and the effect of the prosthesis on the perceived mobility level with the "Mobility" subscale of the "Prosthesis Evaluation Questionnaire". In the intergroup comparisons, the change in the stabilization strength of deep spinal muscles, maximal energy expenditure and exercise capacity values were found to be statistically significant in both groups (p<0.05). In the comparison between groups, the changes in the stabilization strength of deep spinal muscles, perceived mobility level, maximum energy expenditure and exercise capacity were found to be significant in favor of the group in which spinal stabilization exercises were applied (p <0.05). As a result of this study, it was determined that although both the classical physiotherapy program and spinal stabilization exercises had a positive effect on the parameters evaluated, spinal stabilization training should be included in the amputatee rehabilitation program. In our study, it was observed that the addition of spinal stabilization exercises to the rehabilitation program increased the exercise capacity, the amount of energy available without fatigue, and the perceived mobility level. Our study will be a guide for professionals working in the field. It is thought that planning and conducting studies in the future for different amputation reasons, with different amputation levels and with a higher number of people will contribute to this field.