The Relationship of Quadriceps and Hamstring Strength on Timed up and go Scores in Transtibial Amputees

Lower limb amputation (LLA) has a significant socioeconomic and psychological impact on both individuals and communities. Despite these effects, major lower limb amputations remain relatively common worldwide. The causes of amputation vary by region, with the majority being non-traumatic in nature-most commonly linked to conditions such as diabetes mellitus, peripheral vascular disease, and cancer.

Individuals with lower limb amputation often experience musculoskeletal limitations, including reduced strength in the residual limb, limited range of motion (particularly in prosthetic joints), and challenges with postural control. As a result, they face a higher risk of falls compared to their able-bodied peers.

There has been limited research over the past two decades examining the use of the Timed Up and Go (TUG) test in adults with LLA. Since muscle strength plays a critical role in functional mobility, assessing the biomechanical and muscular conditions of individuals with amputation is essential for restoring daily function.

Unilateral amputation causes biomechanical asymmetries, making it important to monitor strength development in both the residual and intact limbs during prosthetic rehabilitation. Strength assessments can support balance recovery, improve movement confidence, and enhance gait performance.

Study Aim This study aims to explore the relationship between quadriceps strength in the amputated limb and Timed Up and Go (TUG) scores in adults with unilateral lower limb amputation. It will also investigate the association between hamstring strength and TUG scores in the same population.

Inclusion criteria

• All participants age 50 years or older, with the reason for amputation either peripheral vascular disease or diabetic complications (Nadollek & Brauer, 2002).
• Unilateral transtibial amputation only (Wood, 2022).
• K-level (2 to 4) (Gailey et al., 2002).
• Normal Body mass index ranged from 18.5 to 30.0 (Nuttall, 2015).

Exclusion criteria

• Residual limb revision in the past six months (Wood, 2022).
• Open wounds or sores on the residual limb limiting the ability to don/doff prosthesis (Wood, 2022).
• Uncontrolled comorbidities such as cardiovascular disease, active cancer treatment, and uncontrolled Diabetes Mellitus (Wood, 2022).