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[Gait Training for Lower Limb Amputees - A Systematic Review Based on the Research Pyramid].

BACKGROUND
Lower extremity amputation patients have gait asymmetries which can lead to further complaints in other joints of the body.


METHOD
Five relevant databases were systematically searched for studies about gait training methods among people with transtibial and transfemoral amputations, followed by an evaluation of the methodical power of the eight references. Subsequently, the studies were categorized into the evidence classes of the research pyramid. The aim was to give treatment recommendations for this patient group.


RESULTS
All training methods show an improvement in gait parameters of the patients. In seven studies at least four different training forms are used within one training intervention. Therefore, a combination of different forms seems promising. A long-term statement among these methods could not be made. Due to the high variability in intervention methods and outcome parameters, an aggregation of data and meta-analyses were not possible.


CONCLUSION
The Evidence-Based Amputee Rehabilitation Program provides a good basis for a standardized training method. It should be supplemented with functional dual-task training and education. In further research a specific duration and intensity of such a program needs to be investigated. On top of that further qualitative and observational research is needed to generate statements which optimize the gait training in the physiotherapeutic routine practice.